Spotting: Causes

Pathogenesis (development of disease)

Spotting can be divided into:

• Premenstrual spotting (pre-lubrication; pre-bleeding; premenstrual spotting).
  • Indication of corpus luteum insufficiency (luteal weakness; premenstrual spotting) with biphasic temperature pattern, hyperthermia phase possibly shortened, progesterone level in the lower normal range
  • Premature decline in estrogen formation
• Middle bleeding (ovulatory bleeding; periovulatory spotting): relative estrogen deficiency due to preovulatory (“before ovulation“) drop in estrogen levels (hormone withdrawal bleeding).
• Postmenstrual spotting (synonyms: postmenstrual spotting; postmenstrual bleeding; postmenstrual spotting):
  • Insufficient regeneration of the endometrium (lining of the uterus) due to estrogen deficiency at the onset of the cycle or insufficient hemostasis in uterine hypoplasia (underdevelopment of the uterus).
  • Delayed regression of the corpus luteum

The cause of spotting is usually hormonal disorders or endometrial causes.

Etiology (causes)

Behavioral causes

• Overweight (BMI ≥ 25; obesity).

Disease-related causes

• Anorexia nervosa (anorexia nervosa)
• Chronic endometritis (inflammation of the uterus).
• Hormonal disorders such as ovarian insufficiency (functional weakness of the ovaries), follicle maturation disorder (egg maturation disorder), corpus luteum insufficiency (luteal weakness).

Medications

• Contraceptives (contraceptives)