Spotting, which is often also associated with intermenstrual bleeding, can occur in addition to normal period bleeding, during pregnancy, or during or after menopause. The causes can be varied. Therefore, they should always be clarified by a doctor.
What is spotting?
Spotting is unscheduled bleeding that can occur in addition to menstruation. It is usually brownish or dark in color and is therefore particularly noticeable. Spotting can also occur during pregnancy and during or after menopause. This is a weak bleeding, also called spotting, which usually lasts only a short time, but sometimes can last for several days. Most women are very confused when spotting occurs, as the reasons for the unexpected bleeding are usually not clear. This is not the only reason why a medical clarification of the causes is advisable. Spotting can have many causes. Often these are harmless and no cause for concern. In some cases, however, quite serious diseases are responsible for an occurring spotting.
Causes
The causes of spotting can be varied. For example, various diseases of the reproductive organs can trigger spotting. These include fibroids, polyps, or inflammation of the uterus or ovaries. Growths outside the uterus (endometriosis) and benign growths on the cervix (portioectopy), as well as other benign or malignant tumors on the internal and external sex organs, can also be the reason for spotting. Often, the unscheduled bleeding also occurs due to hormonal imbalances. These include spotting that occurs when taking contraceptives such as the pill, but also at the beginning of pregnancy. Light bleeding also occurs in an ectopic pregnancy. Injuries to the blood vessels, for example after sexual contact or by wearing an IUD, can also lead to spotting. In addition, psychological stress, various metabolic diseases, and liver and kidney diseases can cause spotting.
Symptoms, complaints, and signs
In most cases, spotting occurs shortly before or after the onset of menstruation. Usually, such spotting is accompanied by fairly clear and typical symptoms. The most obvious symptom of spotting is visible to the naked eye. A mucous and mostly reddish fluid comes out of the vagina. The amount can vary greatly from woman to woman. Since spotting often occurs shortly before the onset of menstruation, it can lead to considerable abdominal pain under certain circumstances. Thus, spotting often serves as a harbinger of the upcoming period. The period is also accompanied by typical symptoms and signs. These include severe pain in the abdominal area, headaches, hot flashes and dizziness. Spotting does not always occur, but it can serve as a harbinger of the upcoming period. In most cases, spotting is associated with pain, but it is short-lived. Visually, spotting differs from periods because of the amount and color. Commercially available and over-the-counter painkillers can provide short-term relief from the pain. However, an occurring spotting is not a clinical picture, so it is not mandatory to resort to taking appropriate medication.
Diagnosis and course
The diagnosis of spotting is always primarily the responsibility of a gynecologist. In women of childbearing age, the physician will first rule out pregnancy. A gynecological examination and ultrasound scans can detect any diseases of the reproductive organs. Any hormonal causes can be diagnosed by blood tests. In the case of an existing pregnancy, a definitive diagnosis depends on the stage of pregnancy. Especially in early pregnancy, spotting is not uncommon and is usually harmless. A possible ectopic pregnancy can be detected by ultrasound examination.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 determined at the first occurrence, repeated spotting may occur.
Complications
Spotting does not necessarily lead to complications. In most cases, the discharge is harmless and occurs as a result of temporary hormonal changes or minute lesions in the area of the endometrium. Pre-bleeding sometimes underlies thyroid disease and this may be associated with infertility. If spotting is due to an estrogen deficiency, this can lead to depressive moods, cardiac arrhythmias, osteoporosis and other health problems. If there are organic causes – for example, inflammation of the endometrium 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 itself result in any further complaints. However, poor intimate hygiene can lead to inflammation, itching and redness. Drug treatment involves the typical risks. Side effects and interactions are possible, and occasionally allergic reactions and symptoms of intolerance occur. If the spotting is due to cancer, chemotherapy or radiation therapy may cause health problems. Hormone treatment or curettage may also be associated with further complications.
When should you see a doctor?
Spotting does not always require seeing a doctor. A visit to the doctor is usually necessary only when spotting occurs frequently and, above all, without any particular reason. Only early diagnosis and treatment of this complaint can prevent further complications and other ailments. Those affected also suffer from very severe pain in the abdomen or lower abdomen and also severe mood swings. If these complaints occur, a doctor should be consulted. A doctor should also be consulted in the event of severe headaches or dizziness if these complaints are associated with spotting. If the spotting occurs only very rarely and also disappears on its own, a visit to a doctor is usually not necessary. Spotting can be examined and treated by a gynecologist. As a rule, this complaint does not reduce the life expectancy of the affected person.
Treatment and therapy
Treatment of spotting always depends on the triggering cause. If there is a disease of the reproductive organs, it is treated accordingly. This can be done with the help of medication, but also by surgical intervention. Hormonal causes can be treated by taking appropriate hormone preparations. If taking the pill or wearing an IUD is the cause of spotting, spotting that occurs can be remedied by removing the IUD or changing the birth control pill. Psychological causes usually require psychological therapy. If other physical diseases are responsible for the spotting, these are treated depending on the underlying disease. An ectopic pregnancy must be terminated surgically. A healthy and fully mature fetus cannot grow in the fallopian tube. For the mother, the further growth of the embryo can mean danger to her life. Both at the beginning and at the end of a normal pregnancy, spotting is usually a harmless phenomenon that stops 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.
Prevention
A sudden onset of spotting cannot be prevented, as the causes can be extremely varied. To avoid repeated spotting with an unexplained cause, it is advisable to have the cause clarified by a doctor as soon as the first unusual bleeding occurs. In this way, a recurrence of spotting can be avoided.
Aftercare
Because persistent spotting that is perceived as distressing often results from irregular hormone levels, therapy will usually consist of an examination of the same and hormone doses. Often this involves the pill. Regardless of the occurrence of further spotting, women who take the pill should have themselves examined by a gynecologist every six months. The administration of other hormone preparations should also be checked by the attending physician, usually by establishing a new hormone level. It is important that affected women keep their follow-up appointments. Hormones can have strong side effects, so close monitoring of the dose can be of great importance. Regular follow-up appointments should also be made after gynecological surgery to ensure that the duration and severity of spotting, which is not uncommon after surgery, does not put a strain on the patient’s health. Many women often experience spotting while taking the pill. Provided that the gynecological diagnosis shows that the spotting has no other causes, it is not necessary to discuss every further spotting with a specialist immediately. Nevertheless, it is important to have regular gynecological check-ups. The main aim here is to rule out the possibility that other causes for the spotting have developed unnoticed.
What you can do yourself
If spotting occurs regularly, affected women should definitely have the cause clarified by a doctor. Cyclic spotting and those due to pregnancy cannot always be treated causally. Those affected should then concentrate on preventing the consequences. For many women, spotting is particularly unpleasant because it cannot be planned and the choice of clothing cannot be adjusted. However, those affected have to come to terms with this and come to terms with these inconveniences as best they can. Those who do not want to wear panty liners all the time should at least have them to hand at all times. In the meantime, these hygiene products are already available in different colors, which allows for particularly discreet use. Black panty liners in particular are almost invisible in black underwear. For on the go, cases are offered that allow hygienic and inconspicuous stowage in the handbag. Individually packaged products are also particularly practical. Those who suffer from heavier bleeding in between should not only always carry tampons, but also spare underwear. Specialty stores and drugstores offer individually packaged disposable panties for this purpose, which also fit into almost any handbag. Moist cleansing wipes, which are also offered individually packaged, ensure that blood and vaginal secretions can be removed at any time.
