Spotting & Cramps


Spotting is a symptom experienced by most women at some point in their reproductive and post-reproductive years. For the most part, spotting and cramping normally accompanies menstruation or occurs as a side effect of oral contraceptives. However, many other conditions can cause cramping and spotting, and while some are temporary and treatable, others are chronic nuisances.

What is Spotting?

  • Spotting is the occurrence of light bleeding. This can happen at any time in a woman's life and may be perfectly normal or indicative of a health condition. Spotting is usually lighter than normal menstrual flow and is usually red, pink or brown in color. Women with conditions that cause fluctuations in the hormone estrogen or progesterone, such as polycystic ovarian syndrome or menopause, may notice spotting more than women who don't have these conditions.

Premenstrual Syndrome

  • During the stage right before your menses, you may experience a set of symptoms known as premenstrual syndrome, or PMS. According to Medline Plus, this occurs about five to 11 days before the menstrual flow. Menstruating women of all ages experience these symptoms, although it is more common among women in their 20s to 40s. The symptoms include headaches, cramping, bloating, mood swings, constipation or diarrhea, weight gain, and painful menstruation. Spotting generally occurs with these symptoms in women who have hormonal conditions such as PCOS. PCOS causes a fluctuation in hormones that may make the menstrual cycle sporadic, or cause uterine bleeding or spotting at any time within the cycle.


  • During ovulation, you may experience ovulation spotting. It can happen midway through your cycle when the ovarian follicle that holds the egg ruptures to let it out. The lining of the ovarian follicle then disintegrates and forms a hole---this is where the egg exits. Along with this egg may come a small amount of blood from the rupture. Ovulation spotting will appear to be brown or pink. Also during ovulation, some women experience cramping known as Middleschmertz. This is the pain that results from the irritation of bleeding from the ovarian follicle. Both of these occurrences are normal and not dangerous.


  • During the early weeks of pregnancy, the fertilized egg burrows its way into the uterine lining, where it will remain attached for the full term of the pregnancy. When the fertilized egg burrows into this thickened uterine lining, blood escapes. You may see this blood in small amounts around the time of your normal menstrual cycle. It may be pink, brown or red. This light bleeding is called "implantation bleeding" or "implantation spotting." You may experience cramping associated with the burrowing and throughout the pregnancy as the uterus expands.


  • Endometrium (endometrial lining) normally grows in the perimeter of the uterine cavity and changes in thickness during the menstrual cycle. In the menstrual cycle, levels of the hormone estrogen peaks to allow the production of an egg. The level then surges, simultaneously signaling the egg to release and the endometrial lining to thicken in anticipation of a fertilized egg. The lining remains thick if conception takes place; this will cushion the embryo and go on to supply the placenta with nutrients and blood. When conception doesn't take place, the egg and endometrial lining begin to break down and shed through the cervix as a menstrual period. Endometriosis is a condition that causes the endometrial lining to grow inside and outside of the uterus. With endometriosis, the abnormally growing lining behaves in the same way as it would in the uterus (pre-pregnancy), causing thickening and bleeding where it grows. This can cause severe cramping, in-between bleeding and spotting.

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