The menstrual period can be very confusing for some women. Periods come in different forms and patterns and it can be difficult determining if a period is normal or not. At the same time, some bleeding can be described as ‘spotting’ and not a period. What then is the difference between spotting and period? How do you know you are experiencing your period and not just spotting? Is it normal to spot? When should you visit a doctor? Here is all you need to know about a period and spotting and how to differentiate between them.
What is a period?
From puberty, at around the age of 10 to 16 years, the reproductive cycle of the natural female begins. This cycle begins from the first menstrual period to the last menstrual period at around 51 years.
The length of the period is variable but it is usually an average of 28 days (25 to 35 days) and is counted from the first day of the bleeding of a period to the first day of bleeding of the next period. The menstrual period in an adult female usually lasts between 2 to 5 days but can be up to 8 days in some women. The amount of blood lost is usually between 5mls to 80mls, and any bleeding more than 80mls is considered heavy. Practically, to estimate the volume of fluid loss, a regular daytime fully soaked pad may hold around 5 mls or a teaspoon of fluid, and a fully soaked overnight pad may hold 10-15 mL, while a fully saturated light tampon can hold up to 3mls of fluid. In summary, it is normal to soak one to seven pads in a whole period.
What happens in a normal period?
The normal period occurs in a phases in the female body. The first phase of the menstrual cycle occurs from the first day of the menstrual cycle and based on a 28-day cycle, it lasts till the 14th day. Here, events happen in the female uterus (womb) that make it ready and able to accept a fertilized egg and subsequently, pregnancy. The linings of the uterus become very rich and there is buildup of blood vessels and nutrients in preparation for pregnancy. The uterus also creates a friendly environment helpful to sperm so it can fertilize the incoming egg that will be released during ovulation. Ovulation which marks the beginning of the second phase, occurs on the 14th day where the mature egg is released. It this egg is fertilized, pregnancy ensures and a period will not come. However, if there is no fertilization (the woman does not have sex or the sperm deposited during sex fails to fertilize the egg), the hormonal levels will decrease and the rich environment in uterus cannot be maintained. The inner lining will then shed the blood which will flow out through the cervix and vagina. This is the menstrual period.
There may be no ovulation in some cases, the period will still occur but will be fluctuating and usually does not reach 28 days and the flow can range from scanty to heavy in such cases.
What is spotting?
Spotting is any light vaginal bleeding that occurs when it is not time for the menstrual cycle.
What causes spotting?
There are several causes of spotting. The causes include:
- Birth control methods. All birth control methods can cause spotting. This includes both the hormonal and non-hormonal methods like pills, injections, implants, uterine inserts, etc.
- Perimenopause: spotting occurs as the menstrual period is gradually winding down and the body is getting used to the reduction in hormones that occurs during menopause.
These two causes are often the commonest causes of spotting and except the spotting is noticed to be getting heavier or there are other associated symptoms like cramps, there is usually no need to be worried in these cases.
- Ovulation: spotting has been reported in a small percentage of women during ovulation. It may occur with mid-cycle ovulation pain which marks the release of the mature egg. There is usually no need to worry about this spotting.
- Pregnancy: spotting can happen at any time in pregnancy from the early period during implantation which is usually about a week to the period date, as the fertilized egg is implanting into the uterus. It can also be a sign of a threatened miscarriage, ectopic pregnancy, or issues with the pregnancy at any stage.
- Other causes of spotting include: Trauma to the cervix or vagina, especially during rough or dry sex, uterine or cervical masses like polyps, sexually transmitted infections, and rarer causes like extreme stress, thyroid disorders, extreme weight gain or loss, diabetes mellitus, and thyroid disorders. It can also be caused by cancer of the uterus, cervix, or vagina.
What is the difference between spotting and period?
Spotting can be differentiated from period in the following ways:
Spotting usually occurs before the date of the actual period, mostly in the middle of the cycle unlike a period.
Spotting is usually pinkish or brownish unlike a period that is often bright red to dark red, and dark brown sometimes depending on the day of the period.
Spotting is usually light and only panty liner may suffice and there may be no need to use a pad unlike a period.
Spotting is usually painless, while a period may be associated with abdominal pains and cramps.
Spotting also is not accompanied by the other symptoms of a period like tender breasts, bloating, mood changes, pimple break outs.
What to do if you are spotting?
Even though some causes of spotting are normal and nothing to worry about, it is a good idea to visit your gynaecologist when you notice you are spotting or the bleeding gets heavier, or there are other associated symptoms like fever, severe abdominal cramps, weakness, and dizziness. Also it is advisable for every pregnant woman who is spotting to visit her doctor to be examined to confirm if it is due to a serious cause or not.