Spotting, which is often associated with intermenstrual bleeding, can occur in addition to normal menstrual bleeding, during pregnancy or during or after menopause. The causes can be varied. Therefore, they should always be checked out by a doctor.


What is spotting?

Spotting is unplanned bleeding that can occur in addition to your menstrual period. It is usually brownish or dark in color and is therefore particularly noticeable. Spotting can also occur during pregnancy and during or after menopause. See biotionary for What does MCS stand for.

This is a light bleeding, also called spotting, which usually only lasts for a short time, but can sometimes last for several days. Most women are very insecure when spotting occurs, since the reasons for the unexpected bleeding are usually not clearly recognizable.

This is not the only reason why medical clarification of the causes is advisable. Spotting can have many causes. Often these are harmless and nothing to worry about. In some cases, however, serious diseases are responsible for spotting that occurs.


The causes of spotting can be varied. Various diseases of the genitals can cause spotting. These include fibroids, polyps or inflammation of the uterus or ovaries. Growths outside the uterus (endometriosis) and benign growths on the cervix (portioectopia), as well as other benign or malignant tumors on the internal and external genitalia can also be the reason for spotting.

Unscheduled bleeding often occurs due to hormonal disorders. This includes spotting, which occurs when taking contraceptives such as the pill, but also at the beginning of pregnancy. In an ectopic pregnancy, there is also slight bleeding. Injuries to the blood vessels, for example after sexual contact or wearing an IUD, can also lead to spotting.

In addition, psychological stress, various metabolic diseases, as well as liver and kidney diseases can cause spotting.

Symptoms, Ailments & Signs

Most of the time, spotting occurs just before or after your period starts. Usually such spotting is accompanied by fairly clear and typical symptoms. Probably the clearest symptom of spotting is visible to the naked eye. A slimy and mostly reddish liquid comes out of the vagina.

The amount can vary greatly from woman to woman. Because spotting often occurs just before your period starts, it can cause severe abdominal pain. Thus, spotting that occurs often serves as a harbinger of the upcoming period. The period is also accompanied by typical symptoms and signs.

These include severe abdominal pain, headaches, hot flashes and dizziness. Spotting doesn’t always happen, but it can serve as a harbinger of an upcoming period. In most cases, spotting is associated with pain, but this is only brief. Visually, spotting differs from a period because of the amount and color.

Commercially available and over-the-counter painkillers can achieve a short-term improvement against the pain that occurs. However, spotting that occurs is not a clinical picture, so it is not absolutely necessary to resort to taking appropriate medication.

Diagnosis & History

The diagnosis of spotting is always primarily the responsibility of a gynecologist. In women of childbearing age, the doctor will first rule out pregnancy. A gynecological examination and ultrasound examinations can be used to determine any existing diseases in the genitals.

Any hormone-related causes can be diagnosed by blood tests. In an existing pregnancy, a definitive diagnosis depends on the stage of pregnancy. Especially in early pregnancy, spotting is not uncommon and is usually harmless. An ectopic pregnancy can be detected by an ultrasound scan.

If the doctor suspects psychological or other physical causes, further examinations by an internist or psychological counseling are necessary to find the trigger. As a rule, spotting lasts only a short time and occurs for a maximum of two to three days. However, if the cause is not identified when it first occurs, spotting may recur.


Spotting does not necessarily lead to complications. The discharge is usually harmless and occurs as a result of temporary hormonal changes or minor injuries to the lining of the uterus. Pre-bleeding is sometimes due to thyroid disease and this may be related to infertility. If the spotting is due to a lack of estrogen, it can lead to depression, cardiac arrhythmias, osteoporosis, and other health problems.

If there are organic causes – for example an inflammation of the uterine lining or polyps – these can also lead to serious complications if left untreated. The spotting itself is therefore usually a symptom of another cause and does not result in any further symptoms. However, a lack of intimate hygiene can lead to inflammation, itching and redness.

Drug treatment carries the typical risks. Side effects and interactions are possible and occasionally there are also allergic reactions and symptoms of intolerance. If the spotting is caused by cancer, chemotherapy or radiation therapy can cause health problems. Hormone treatment or a curettage may also be associated with further complications.

When should you go to the doctor?

It is not always necessary to see a doctor if you have spotting. A visit to the doctor is usually only necessary if the spotting occurs frequently and above all without a specific reason. Only with an early diagnosis and treatment of this complaint can further complications and other complaints be prevented. Those affected also suffer from very severe pain in the stomach or abdomen and also from strong mood swings.

If these symptoms occur, a doctor should be consulted. A doctor should also be consulted in the event of severe headaches or dizziness if these symptoms are associated with spotting. If the spotting occurs very rarely and goes away on its own, a visit to a doctor is usually not necessary. The spotting can be examined and treated by a gynecologist . As a rule, this complaint does not reduce the life expectancy of the person affected.

Treatment & Therapy

The treatment of spotting always depends on the triggering cause. If there is a disease of the genitals, it will be treated accordingly. This can be done with the help of medication, but also through surgery. Hormonal causes can be treated by taking appropriate hormone preparations.

If taking the pill or wearing an IUD is the cause of the spotting, any spotting that occurs can be eliminated by removing the IUD or changing the birth control pill. Psychological causes usually require psychological therapy. If other physical illnesses are responsible for the spotting, they will be treated depending on the underlying illness.

An ectopic pregnancy must be terminated surgically. A healthy and fully mature fetus cannot grow in the fallopian tube. The further growth of the embryo can mean life-threatening danger for the mother. Both at the beginning and at the end of a normal pregnancy, spotting is usually a harmless phenomenon that will stop on its own without further treatment. In an existing pregnancy, the doctor must decide on a case-by-case basis whether spotting needs to be treated.


A sudden onset of spotting cannot be prevented, as the causes can be extremely varied. In order to avoid repeated spotting with an unexplained cause, it is advisable to have the cause clarified by a doctor as soon as unusual bleeding occurs. In this way, renewed spotting can be avoided.


Since persistent spotting, which is perceived as stressful, often results from an irregular hormone level, the therapy will usually consist of an examination of the same and hormone administration. This is often the pill. Irrespective of the occurrence of further spotting, women who take the pill should be examined by a gynecologist every six months.

The administration of other hormone preparations should also be checked by the doctor treating you, usually by creating a new hormone level. It is important that affected women keep the appointments for follow-up care. Hormones can have powerful side effects, so close dose control can be important.

Regular follow-up appointments should also be arranged after gynecological operations to ensure that the duration and intensity of the spotting, which is not uncommon after operations, does not put a strain on the patient’s health. Many women often experience spotting while taking the pill.

If it has been clarified by a gynecologist that the spotting has no other causes, it is not necessary to immediately discuss every further spotting with the specialist. Nevertheless, it is also important here that regular gynecological check-ups take place. The main aim here is to rule out that other causes of the spotting have developed unnoticed.

You can do that yourself

If spotting occurs regularly, the affected women should definitely have the cause clarified by a doctor. Cyclic spotting and those that can be traced back to pregnancy cannot always be treated causally. Those affected should then concentrate on preventing the consequences. For many women, spotting is so uncomfortable mainly because it cannot be planned and the choice of clothes cannot be adjusted. However, those affected have to come to terms with this and come to terms with these inconveniences as best they can.

If you don’t want to wear panty liners all the time, you should at least have them on hand at all times. These hygiene products are now available in different colors, which allows for particularly discreet use. Black panty liners in particular are almost invisible in black underwear. Cases are offered for on the go, which enable hygienic and unobtrusive storage in the handbag. Individually wrapped products are also particularly practical.

Anyone who suffers from heavy bleeding should not only always carry tampons, but also spare underwear. Individually packaged disposable panties are available in specialist shops and drugstores, which also fit in almost every handbag. Moist cleaning wipes, which are also available individually packed, ensure that blood and vaginal secretions can be removed at any time.