What is Spotting or Breakthrough Bleeding?
Spotting, also called breakthrough bleeding, is light or very light bleeding or discharge that occurs at any point in your menstrual cycle between periods. Some women have it before their period is due. Some have it midcycle around ovulation. Others have it for a few days after their period ends. The color of the blood may be light pink, red, brown or dark red, or purple.
What Causes Spotting?
There are a number of possible explanations for bleeding between periods:
- Implantation Bleeding/Pregnancy – Spotting sometimes happens at conception and indicates early pregnancy. If you experience it and you have a late period or there is any chance you are pregnant, it’s best to see your doctor or do a pregnancy test to confirm.
- Miscarriage – The beginning of a miscarriage can look like light spotting. It’s best to see your doctor if you are pregnant, especially in the first trimester and experience any bleeding.
- Ectopic pregnancy – Cramping, abdominal pain, and spotting can be signs of ectopic pregnancy. Ectopic pregnancy is a medical emergency. If you are experiencing these symptoms and are or may be pregnant, it is best to see your doctor or go to the emergency room.
- Hormonal fluctuations or imbalance – This is one of the most common causes of spotting in women who are not pregnant. It appears at times of hormonal change, like just before your period and mid-cycle at ovulation.
- Starting, stopping, changing or missing birth control pills – Inconsistent use of the birth control pill causes hormone changes that trigger spotting. Even proper use of the birth control pill can lead to bleeding if the pill isn’t the right one for you.
- Hypothyroid and spotting – Low thyroid hormone levels (low T3 or T4, high TSH) or an underactive thyroid causes irregular periods and irregular bleeding.
- Stress – Under stress, your body will redirect progesterone into stress hormones. This lowers your progesterone and causes irregular bleeding when there shouldn’t be.
- IUDs occasionally cause slight spotting, especially after it is initially inserted. This is normal.
- Injury to the vagina or cervix from the insertion of objects like vibrators or tampons – Tearing of your vagina from any kind of trauma leads to bleeding.
- Vaginal infection – Vaginal infection causes spotting. Suspect this if it is accompanied by signs of infection like irritation, itching, burning, and other discharge.
- Tumors, polyps or fibroids of the vagina, cervix, uterus or fallopian tubes cause irregular bleeding. See your doctor for a pelvic and transvaginal ultrasound.
- Vaginal dryness – at perimenopause and menopause. The vaginal tissue becomes drier, thinner and more easily irritated which causes bleeding.
- GYNE procedures – For example, after a PAP smear or D&C spotting is quite common.
- Some women spot during ovulation, which may or may not be normal. See your doctor for assessment.
What Should I do About Spotting?
In most of the above instances, spotting doesn’t pose an immediate threat to your health. But, you should see your medical doctor as soon as possible for some diagnostic testing to determine the cause if you are experiencing breakthrough bleeding and if:
- There is no known explanation like IUD insertion, change in birth control pill or a recent PAP smear.
- You are pregnant or think you might be pregnant, it’s best to see your doctor immediately.
- If there are signs of an underactive thyroid or hypothyroid, have your thyroid assessed through blood work (TSH, free T3, and free T4). Signs of hypothyroid include: easy weight gain, feeling cold often, excessive hair loss on your head, tiredness, sluggishness, and being lethargic or dull-witted. If these levels indicate that you are hypothyroid, your doctor can also check to see if you have Hashimoto’s disease. This is an autoimmune thyroid disorder. Your thyroid gland can be underactive because of a nutritional deficiency, because of an autoimmune condition or for unexplained reasons. Naturopathic treatment of hypothyroidism involves nourishing the thyroid with all the nutrients it needs. In the case of Hashimoto’s, we remove the immune activation that is causing the thyroid attack.
- You should also see your physician if you have:
- a history of an abnormal PAP smear
- a suspicion of any serious condition of your reproductive organs for any other reason.
- signs of hormonal imbalance such as:
What is the Natural Treatment for Breakthrough Bleeding?
As always, with naturopathic medicine, we address the root cause of the problem.
Diet, stress reduction, exercise, herbs, vitamins, and minerals fix hormone imbalances (polyps, fibroids, endometriosis, PCOS, cysts). For menopause and perimenopause symptoms we support your entire endocrine system. Thyroid disease improves through diet, nutritional support, and moderating your immune system. Abnormal PAP’s improve by supporting your immune system to fight the HPV virus, anti-viral herbs, vitamins, minerals, and immune-boosting herbs.
Want help with spotting or any other health problem? Book an appointment here or call 416-481-0222 for more information.
Authored by Dr. Pamela Frank, BSc(Hons), ND
Dr. Pamela has been in practice as a naturopathic doctor in Toronto since 1999. She has been the recipient of numerous “Best Naturopath in Toronto” awards. She is registered with the College of Naturopaths of Ontario.
Dr. Pamela Frank uses a natural treatment approach that may include acupuncture, herbal medicine, nutrition, diet, vitamins, supplements, and other natural remedies to restore balance and provide long-term resolution of almost any health problem.
Spotting or Breakthrough Bleeding Research
Investigation of Women with Postmenopausal Uterine Bleeding: Clinical Practice Recommendations. Source: Perm J. 2014 Winter; 18(1): 55–70. doi: [10.7812/TPP/13-072]