Spotting: Causes

What causes spotting?

The causes of spotting can vary depending on a woman's age and her stage in life. Spotting can be normal in young women in the first few years of their menstrual periods and in women approaching menopause. Hormonal contraceptives or hormone therapy are also common causes of spotting.

In other cases, spotting is caused by abnormalities in hormone balance.

Gynecologic causes of spotting

Spotting may be caused by gynecologic disorders including:

• Cyst (benign sac that contains fluid, air, or other materials)
• Endometrial hyperplasia
• Menorrhagia (heavy bleeding during menstrual period)
• Uterine fibroids or noncancerous tumors of the uterus
• Uterine polyps or masses in the endometrium

Hormonal causes of spotting

Spotting can also be caused by hormonal imbalances including:

• Changes in levels of estrogen or progesterone
• Hormonal contraceptives (birth-control pills, patch or injection; intrauterine devices)
• Hormone therapy
• Hyperthyroidism (overactive thyroid)
• Hypothyroidism (underactive thyroid)

Serious or life-threatening causes of spotting

In some cases, spotting may be a symptom of a serious or life-threatening condition that should be immediately evaluated. These conditions include:

• Cancers of the cervix, uterus, ovary or vagina
• Ectopic pregnancy (life-threatening pregnancy growing outside the uterus)
• Pelvic inflammatory disease (infection of the internal genital organs)

Questions for diagnosing the cause of spotting

To diagnose your condition, your doctor or licensed health care provider will ask you several questions related to your spotting including:

• Are you pregnant?
• When did you first notice the spotting?
• Have you noticed any changes in your menstrual periods?
• Is your menstrual period heavy or prolonged?
• Have you missed any menstrual periods?
• Do you have any other symptoms, such as fatigue or rapid heart rate?
• What medications are you taking?

What are the potential complications of spotting?

Because spotting can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

• Anemia (low red blood cell count)
• Cancer of the uterus
• Frequent serious or opportunistic infections
• Inability to participate normally in activities
• Spread of cancer
• Spread of infection
•  

References:

Menstrual periods - heavy, prolonged, or irregular. MedlinePlus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003263.htm. Accessed May 17, 2011.

Abnormal menstrual periods. UCSF Medical Center. http://www.ucsfhealth.org/conditions/abnormal_menstrual_periods/index.html. Accessed May 17, 2011.