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What’s the Bloody Difference: True Period vs. Spotting

What’s the Bloody Difference: True Period vs. Spotting

February 28, 2024

Ever had one of those days where you’re dressed up super cute, it’s sunny, you’re meeting up with friends for a little Sunday Funday, and you go to the bathroom to find blood in your underwear? Me too. And you can swear on your mom and grandma and hairstylist that you are MOST DEFINITELY not on your period. Yep. Been there. So, if you’re not on your period then why on earth is there blood in your underwear?! Let’s talk about true periods versus spotting and reasons why we may spot.

THE O.G. aka True Period

First, let’s quickly break down what we define as a “true period,” aka the menstrual cycle. Sparing you all the big medical terms, a true period can be defined as the monthly shedding of the uterine lining. We know our female bodies are full of hormones and around that time of the month, our hormones are reaching levels that mean it’s time to shed the inner lining of the uterus. Cue the classic changes in mood and cramping and days of bleeding. In a healthy, normal uterus-owning individual periods are fairly predictable. They come every 28ish days. Like clockwork. True periods are the result of the perfect combination of hormone levels indicating to our body that a baby will not be finding its home in the uterus, and it’s time to clean house. Makes sense, right?

New Girl in Town aka Spotting

Alright, so now that we know what causes a true period it’s time to look at why we spot. WHY US!? Isn’t bleeding once a month for 5-7 days enough? I mean, c’mon, right? If only. Spotting, unlike true period bleeding, is usually much lighter, unpredictable and can last for a day or three and disappear and then maybe come back days later. Basically, mercury in retrograde but in your uterus. Cool, cool, cool. To be fair though, we can place the blame on more than just a planet being silly and wreaking havoc.

Most common reasons for spotting (this is not an exhaustive list nor in order of most to least common):

Common Reasons for Spotting

Ok, that’s a lot of reasons to be bleeding and spotting. You’re saying that if I’m spotting it could be pregnancy or cancer or just a mishap with my birth control?! That’s upsetting. Should I be panicking every time I start to spot? No. Take a deep breath with me. Let me first just validate the concern here and say that spotting can feel unsettling and scary. I can relate, I’ve been that panicked person before too. While there are a lot of reasons one might experience spotting, we can usually trace it all back to hormones.

As we know, our hormones are some strong-willed baddies. Spotting is typically the result of a hormone imbalance in our bodies. The concoction is off basically. Kind of like a cookie with raisins instead of chocolate chips. Close, but just not right. (No hate to all you raisin lovers out there! We still love you, but I mean, have you tried chocolate?!). Our uterus is a temperamental little thing, and if things are even slightly off, she throws a fit. I mean who can blame her, right? For the sake of simplicity let’s agree that we aren’t pregnant, we test negative for STIs, and hallelujah, we don’t have cancer. That means the culprits here are our favorite besties.

Meet the Duo: Estrogen and Progesterone

I want to give our hormones the spotlight they are so desperately craving. I’m sure you’re familiar with estrogen and progesterone. If estrogen were a star sign, she’d be a Leo and progesterone would be an Aquarius (IYKYK). Estrogen loves attention, and she is pickier than the typical millennial on a dating app. Type A vibe. Progesterone is her bestie which helps balance her out. Actually, they both help balance the other. If there is too much estrogen and too little progesterone, brace yourself. With irregular bleeding or spotting, the cause is often the result of too much estrogen or too little progesterone. We see this when we start a new form of birth control, miss a dose or two or three (set your birth control reminder alarms, please!), or stop and restart. We also see this with disorders like PCOS and hypothyroidism which both have imbalances in other hormones that directly affect the levels of progesterone and estrogen.

Spotting, Guilty as Charged. Now What?

You’ve identified that you are most definitely spotting and not on your period, so now what do you do? Great question. Because there are several reasons spotting can occur, it’s best to check with your healthcare provider if you have questions or concerns about your symptoms. As we discussed, spotting is an indicator that something is not quite right. It shouldn’t be a reason to go into full chaos freak-out mode, but it does require us to pay attention. You and your healthcare provider know your body and history best, so it’s never a bad idea to make that appointment. Remember the best healthcare providers to address these concerns with are those who specialize in sexual and reproductive medicine, and this includes obstetricians and gynecologists, OB/GYN physician assistants, certified nurse midwives, and women’s health nurse practitioners. Alright besties, do you think you know the bloody difference between a true period and spotting now? I hope you do!

Disclaimer: All information provided in this blog is for education and information purposes only and should not be considered medical advice or instruction. Do not take action solely on the contents of anything expressed or addressed in this blog. Talk to your healthcare provider to know what is normal versus abnormal for you and your body.

  • Marjie Searcy

    Marjie Searcy is a board-certified women’s health nurse practitioner. She graduated with her Masters of Science in Nursing from Georgetown University where she received a dual degree in nurse midwifery and women’s health. Originally her plan was to practice as a holistic midwife, but she discovered a strong passion and love for the world of gynecology and the need for high quality women’s care. Her desire is to provide patient-centered and trauma-informed care that leaves her patients feeling seen, heard, and empowered. She wants to prove that going to see your gynecologist doesn’t and shouldn’t have to be scary whether you are an adolescent or postmenopausal.

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claire coder,
founder + ceo

Hi! I’m Claire. I founded Aunt Flow after getting my period in public without the supplies needed.

At 18 years old, I dedicated my life to developing a solution to ensure businesses and schools could sustainably provide quality period products, for free, in bathrooms. Our products are made with organic cotton and we are constantly working to reduce our environmental impact! Since 2021, we've donated over 5 MILLION period products to menstruators in need. I call this people helping people. PERIOD.®

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