“Why is it that I’m spotting but no period has occurred?” Before you worry that you are pregnant or that something is wrong with you, relax and find out if you are just stressed. That is because in most cases, hormonal changes occur with certain life changes, causing menstrual changes such as spotting. Spotting is vaginal bleeding that occurs between two menstrual periods. Some women notice light spotting without a period. In many cases, there is nothing to worry about, although certain conditions that need medical attention may also be possible.

Spotting But No Period—Why?

Many women go to their doctors and say, “I’m spotting but no period.” Small amount of bleeding before a menstrual period is often harmless, but continuous spotting may indicate a health problem. Here are the possible causes to answer why there is spotting without period:

1.     Common Causes

• Light spotting may occur when you ovulate or release an egg from your ovary.
• Spotting may occur during implantation (implantation bleeding), which occurs when a fertilized egg attaches to the inner wall of the uterus. In this case, 'spotting but no period' becomes an early sign of pregnancy.
• Physical or mental stress, poor diet, lifestyle changes, environmental factors, alcohol abuse, heavy smoking, certain medications, and drug abuse can cause hormonal imbalance. These factors cause a delay in your periods and spotting between the periods and answer the question “why I’m spotting but no period has occurred.”
• For some women, spotting is a sign that their menstruation is imminent or about to begin within one to two days, or at most, after a week.
• One of the side effects of birth control pills is spotting and irregular cycles. Other birth control methods associated with spotting include intrauterine devices (IUDs) and patches.
• Certain medications like aspirin and ibuprofen, which could cause thinning of the blood.

2.     Gynecological Problems

• Spotting accompanied by pain or discomfort during intercourse may be due to growth of uterine fibroids.
• Endometriosis is painful and in this condition, tissue that normally lines the inside of your uterus – the endometrium – grows outside your uterus.
• Polycystic Ovarian Syndrome (PCOS) is the abnormal growth of ovarian cysts due to unusually high levels of androgen, which can lead to spotting but no period.
• Other gynecological causes of spotting include vaginal dryness and irritation, uterine prolapse, vaginal infection, uterine/cervical infection, sexually transmitted disease, ovarian cancer, cervical cancer, and uterine cancer.
• Spotting can occur during the perimenopausal period or just before you enter menopause. Other symptoms include mood swings, hot flashes, difficulty sleeping, vaginal dryness, and other genital and urinary changes. Bleeding can be heavier during the initial stage, but becomes lighter during the later stages of perimenopause.

3.     Pregnancy-Related Issues

• As mentioned above, spotting but no period may be a sign of pregnancy, but sometimes vaginal bleeding occurs in early pregnancy because of low levels of progesterone.
• Spotting in pregnancy accompanied by abdominal cramping can be a sign of a miscarriage. Consult your doctor immediately.
• Spotting for a couple of days, followed by abdominal or pelvic pain, lightheadedness/dizziness can be signs of ectopic pregnancy. In this case, the fertilized egg is implanted outside the uterus and a pregnancy test may be negative. Immediate evaluation and diagnosis is important because this is a life-threatening situation.
• Spotting or light bleeding in breastfeeding women can be a sign of the return of their fertility.

4.    Other Medical Causes

• Thyroid gland disorders
• Obesity, diabetes, and other hormonal imbalances
• Anemia
• Insulin resistance, which can lead to lowering of progesterone levels and miscarriage
• Rapid weight loss
• High-intensity exercise

This list of possible causes of why “I’m spotting but no period” suggests that it is advisable for women to consult their gynecologist when she notices something wrong. However, if you have a yellowish, foul-smelling vaginal discharge, it may not be spotting but a vaginal infection.

Spotting But No Period—What to Do?

Rule Out Pregnancy and Ectopic Pregnancy

The best way to determine if your spotting is due to pregnancy is to take a pregnancy test, which detects the presence of a hormone called human chorionic gonadotropin (hCG) in the urine. It is produced by the body after fertilization. If your period is late and you notice spotting, take a home pregnancy test to check for hCG in your urine.

It is best to take the pregnancy test early in the morning when it contains a large amount of hCG. Repeat the test or consult your doctor after a few days if your first test is negative and your period does not come.

Consult a doctor immediately if you are spotting and you feel symptoms like pelvic/ abdominal pain and dizziness. An ectopic pregnancy must be ruled out.

Spotting between menstrual periods may be prevented by:

• Using birth control pills as directed. One of the common causes of spotting is skipping, stopping, or restarting birth control.
• Limiting aspirin intake. Ask your doctor about switching to medications.
• Getting screened for cervical cancer through Pap smear
• Maintaining a healthy weight to reduce your risk of uterine cancer
• Asking your doctor about changing your birth control method
• Managing stress with relaxation techniques such as meditation, visualization, yoga, deep breathing, and aerobic exercises
• Keeping a menstrual diary to help your doctor evaluate your spotting between periods

In many cases, spotting but no period is normal. Women have unique menstrual patterns, and spotting may not be serious. However, if spotting significantly affects your usual menstrual pattern or if you have other symptoms, call your doctor for proper evaluation and treatment.

Click here to learn more about differences between spotting and period.