Spotting Before Period

Spotting before period or premenstrual spotting is a common problem. The causes could be serious or benign and it requires an extra menstrual hygiene precaution.

What Is Spotting  or Bleeding Before Period?

Spotting is mild bleeding that usual appears as a brown or pink
stain on the underwear. It is not overt, bright red bleeding that occurs
as in normal menses.

Premenstrual spotting occurs about 2-4 days before the overt menstrual bleeding. It therefore occurs during the luteal phase of the cycle.

Causes Of Premenstrual Spotting

The causes are diverse, from trivial to more serious ones which require prompt medical evaluation and treatment.

1. Low progesterone. Progesterone is the major hormone of the luteal phase. Insufficient levels are the major abnormality of the Luteal Phase Defect.
2. Ovulation. There might be spotting or mild bleeding associated with the release of the egg. Also called mid cycle bleeding. This sort of spotting usually occurs early in the luteal phase, more than 8 days before menstrual bleeding.
3. Birth control methods.
   Most modern birth control methods use hormones which may affect the
   uterine lining and cause spotting or even bleeding. This sort of
   spotting is not limited to luteal phase. The kind of bleeding is usually
   called break through bleeding.
4. Pregnancy.
   If pregnancy occurs after ovulation, there might be some spotting
   before the expected date of menses, which of course will be missed!This
   is called implantation bleeding.
   Pregnancy causes a one time premenstrual spotting and not a regular
   month-after-month spotting. An ectopic pregnancy is a serious possible
   cause of luteal phase spotting.
5. Hormonal imbalance. Medical conditions such as thyroid disorders or medications such as aspirin may cause spotting.
6. Genital diseases. Diseases such as fibroids, pelvic infections, ovarian cysts or genital tract cancer may produce spotting or bleeding.
7. Endometrial biopsy. This may leave a few months of premenstrual spotting on its wake.

What Do I Do?

Vaginal spotting like bleeding must be explained. This is even more important in cases of recurrent premenstrual spotting.

Seek
medical care for all cases of 2 or more episodes of spotting before
menses for proper evaluation. It is not wise to assume any cause before
objective medical evaluation.

Disease-specific treatments will be
instituted for every specific cause identified whenever appropriate. In
some few cases, no specific cause might be identified and treatment may
become challenging. In these cases, a trial of progesterone
supplementation may be helpful. Reading more about this condition and
discussing with your doctor is a good idea!.

If you suspect you might be having a very early pregnancy,  you may be having an implantation bleeding. You may want to read is this implantation bleeding?

Not sure what is going on? Contact Doc.

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