May 2, 2025, 8:00 am | Read time: 2 minutes
Approximately every four weeks, a person has their period. However, sometimes there are also instances of spotting. What causes this? And what does it mean if there is unexpected bleeding during pregnancy? STYLEBOOK discussed these questions with a gynecologist.
For some women, the cycle lasts longer, while for others it is somewhat shorter. Anything between 21 and 35 days is considered normal. It is less normal to have spotting outside of the period. This can indicate a serious condition.
Hormones and Excess Fat Tissue
Spotting occurs, as the name suggests, between two menstrual periods. “It is usually less pronounced and does not last long,” explains Dr. Mandy Mangler, chief physician for gynecology and obstetrics at Berlin’s Vivantes Auguste-Viktoria Hospital. A possible trigger is hormonal changes, such as those that occur during puberty or menopause.
“Spotting can also occur if you forget to take the birth control pill or if the IUD is not effective,” says the gynecologist. Thyroid problems can also cause spotting. Besides hormonal triggers, there are other possible causes. “People with a lot of fat tissue experience spotting more frequently,” Mangler says. “This is because the tissue itself is better supplied with blood.”
Organic Diseases
The chief physician for gynecology and obstetrics advises seeing a doctor if spotting occurs more than once. Bleeding can indicate a serious condition, such as polyps or cancer. Especially in women going through menopause, bleeding can be a warning sign. “Everyone should take this very seriously and get checked as a precaution,” warns Dr. Mandy Mangler. “Ignoring the bleeding and doing nothing risks allowing the cancer to spread unchecked.” One of the most common pelvic diseases in women is endometriosis. “However, spotting is rather rare in this case,” the gynecologist notes.
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Spotting During Pregnancy
“Thirty percent of all women experience spotting during pregnancy,” explains Dr. Mandy Mangler. This can be due to the fact that the tissue is significantly better supplied with blood during pregnancy. “Like a nosebleed, the tissue can tear and bleed,” says the gynecologist. This is harmless in itself — just as it is when bleeding occurs from the edge of the placenta.
“This happens when tissue layers move against each other, creating shear forces between the placenta and the uterus,” explains Dr. Mandy Mangler. However, bleeding can also become dangerous. This is the case, for example, with a tear in the uterus or if the placenta detaches. The gynecologist recommends seeking medical advice more often rather than less.