Spotting between periods is relatively common, but it can have several different causes. Here’s a concise overview to help you understand what might be going on and when to seek medical advice. What commonly causes intermenstrual spotting

• Hormonal fluctuations
  • Normal variations in hormone levels can cause light spotting between cycles, especially around puberty, perimenopause, or while adjusting to birth control methods.
• Birth control and hormonal contraception
  • Breakthrough bleeding is common in the first few months after starting hormonal methods (pills, patches, rings, injections, implants). It can also occur with changes to your regimen.
• Uterine or cervical polyps
  • Benign growths in the lining of the uterus or cervix can lead to light bleeding between periods.
• Uterine fibroids or endometrial changes
  • Noncancerous growths (fibroids) or other endometrial changes can cause spotting.
• Infections and inflammation
  • Cervicitis, endometritis, or other infections (including some sexually transmitted infections) can cause abnormal bleeding between periods.
• Gynecologic conditions
  • Endometriosis, adenomyosis, or other uterine/lower-tract conditions may manifest as irregular spotting.
• Pregnancy-related causes
  • Implantation bleeding or very early pregnancy changes can produce light spotting; ectopic pregnancy or miscarriage are serious possibilities if accompanied by pain or heavy bleeding.
• Medical conditions and medications
  • Bleeding disorders, thyroid problems, liver or kidney disease, or certain medications (including anticoagulants) can alter bleeding patterns.
• Less commonly, more serious issues
  • While rare, vaginal or uterine cancers can present with irregular bleeding in some individuals, particularly if you are over 40 or have other concerning symptoms.

When to seek medical evaluation promptly

• Bleeding is heavy, persistent, or lasts longer than a few days.
• You have severe or increasing pelvic or abdominal pain, dizziness, or fainting.
• You have recently becomepregnant or there’s a possibility of pregnancy and bleeding is present.
• You have risk factors or a history of gynecologic conditions, or you notice a significant change in your normal cycle.
• You experience fever, unusual vaginal discharge, or a foul smell with bleeding.

What you can do now

• Track your cycle: note when spotting happens, its duration, and any associated symptoms (pain, discharge, intercourse, pregnancy signs).
• Review recent changes: consider any new or adjusted hormonal contraception, recent illnesses, stress levels, weight changes, or travel.
• Home management: mild spotting accompanying a regular cycle often doesn’t require treatment. If you’re on hormonal contraception, breakthrough bleeding is sometimes managed by continuing the method or discussing options with a clinician.
• When to test: if pregnancy is possible, consider a home pregnancy test and follow up with a clinician as needed.

If you’d like, share a few details:

• Your age and menopausal status
• Current or recent use of hormones (birth control methods, hormones, etc.)
• Any associated symptoms (pain, heavy bleeding, fever, discharge)
• Past gynecologic history (fibroids, polyps, endometriosis, infections)

This will help tailor the information and next steps.