Stress Can Cause Spotting — Here's Why It Happens and What to Do
Stress can spike cortisol levels, disrupting the body's production of sex hormones like estrogen. This can result in spotting and other menstrual changes.
Spotting generally occurs as small droplets of blood in your underwear or as a pink, red, or brown tinge in your discharge.
'The color of your spotting is determined by the amount of time that's passed since the blood was released from the lining of the uterus,' says Jane van Dis, MD, OB-GYN, a medical advisor with menstrual company FLEX.
It typically occurs on either side of your menstrual period (before your period starts in earnest or after you think it has ended), but it can happen at any point in your monthly cycle.
Keep reading to learn more about how stress affects your menstrual cycle and how to manage it.
How stress affects your menstrual cycle
High stress levels can prompt your endocrine system to release stress hormones, including cortisol, a steroid hormone produced by your adrenal glands.
The entire endocrine system is connected, and increased cortisol can have a ripple effect. When cortisol levels rise, both estrogen and testosterone can decrease.
Likewise, fluctuating sex hormones can also affect your stress levels. An unexpected change in your estrogen levels can disrupt your menstrual cycle, resulting in spotting, missed menstruation, or other irregularities.
'Anything that impacts you as a person has the potential to impact the menstrual cycle and therefore cause spotting,' explains reproductive health specialist Felice Gersh, MD, author of 'PCOS SOS: A Gynecologist's Lifeline To Naturally Restore Your Rhythms, Hormones, and Happiness.'
The stress may contribute to spotting if you recently experienced a life change. Causes can include changes like:
a breakup
moving
increasing work responsibilities or losing your job
a recent diagnosis, whether your own or a loved one's
Stress-induced spotting is usually accompanied by other symptoms of stress, including:
difficulty sleeping
difficulty concentrating
changes in appetite
generalized fatigue
muscle aches
digestive upset
sexual dysfunction
Illnesses can also cause physical stress that may have a similar effect.
How to manage stress-related spotting
'Spotting, by its name, implies that an individual is releasing a smaller amount of blood than they would during their period,' says van Dis.
A panty liner should be enough to protect your underwear. If you choose to free-bleed (menstruating without blocking or collecting menstrual blood) and end up staining your underwear, blood-removal tips can help.
However, if you are bleeding so much that you need a sanitary pad or tampon to catch the blood, it is likely too much to be considered spotting. You may have another type of vaginal bleeding.
If the bleeding isn't from stress or your menstrual period, it's best to talk with a healthcare professional about your symptoms. Other causes of abnormal vaginal bleeding can include:
pregnancy or miscarriage
a growth in your uterus or cervix
hormone imbalance
medication changes
an infection
breakthrough bleeding
Cycle-related changes also occur with perimenopause. This is the phase that precedes menopause.
Managing stress to prevent stress-related menstrual changes
Managing your overall stress levels can help reduce stress-related spotting.
'You could incorporate meditation, journaling, grounding, or nature walking into your routine,' says Gersh.
Other stress reduction methods she recommends include:
physical therapy
massage therapy
acupuncture from a licensed practitioner for myofascial release therapy, deep tissue massage, or another form of bodywork
Prioritizing your overall health can also help you manage your stress levels. That means:
drinking enough water
eating nutrient-dense meals
monitoring caffeine intake
getting regular physical activity
limiting alcohol, nicotine, and other substance use
If you continue to feel stressed, less focused, or more irritable than usual, it may be time to talk with a mental health professional. The right therapist can help you deduce the root of your stress and give you tools to manage it.
When to consult with a doctor or other healthcare professional
'If you have a regular period and this is your first time spotting, you'd be wise to rule out pregnancy as the underlying cause if there's a chance that you could be pregnant,' says Gersh.
You can find out if you're pregnant by taking an at-home pregnancy test 10 or more days after you last had vaginal intercourse with a person who produces sperm.
You can also ask a healthcare professional to order a blood test, which can usually detect pregnancy a few days earlier.
If this is the first time you've ever spotted and there's no chance you're pregnant, Gersh says it's probably OK to assume that stress, or some other lifestyle change, is the cause.
But if you're experiencing other unusual symptoms or bodily changes, she recommends consulting a healthcare professional.
Frequently asked questions
What does stress spotting look like?
Spotting usually looks like light bleeding in your underwear. It can be pink, red, or brown and may occur with other discharge. It's typically a small amount (enough that you could use a pantyliner but not need a pad or a tampon).
Spotting usually looks like light bleeding in your underwear. It can be pink, red, or brown and may occur with other discharge. It's typically a small amount (enough that you could use a pantyliner but not need a pad or a tampon).
What can trigger spotting?
Some possible triggers for light bleeding between periods can include stress, changing or skipping hormonal birth control, rough sex, or implantation bleeding due to pregnancy. If you have more than a small amount of blood, there could be another cause.
Some possible triggers for light bleeding between periods can include stress, changing or skipping hormonal birth control, rough sex, or implantation bleeding due to pregnancy. If you have more than a small amount of blood, there could be another cause.
Why am I only spotting when I wipe?
If you only notice blood when you wipe after urinating, you may want to get checked out for other causes of bleeding, such as a urinary tract infection (UTI), which can cause blood in your urine.
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