For many, the week after your period is a magical time. You can confidently step away from the heating pad, place your secret stash of mini chocolate bars back in the pantry (if you must), and finally put your period undies away for a few weeks.

All is right in the world… until you look down at your pristine white undies and find them in not-so-pristine condition. Hold the phone — why am I spotting one week after my period?

Don’t panic! Bleeding between menstrual cycles is pretty common and may be due to a handful of different causes. From changes in birth control, and hormonal changes, to post-pap smear bleeding, we’ll dive into all the possible reasons you could be experiencing breakthrough bleeding or spotting between periods below.

birth control

Birth control options come in all shapes and sizes (and, if you use oral contraceptives, colors!). Some prefer over-the-counter, non-hormonal options, like condoms and diaphragms. Others use hormonal contraceptives such as:

1. Daily birth control pill (oral contraceptives)

2. The birth control implant (placed under the skin of your arm)

3. An intrauterine device (IUD)

4. The birth control shot, which you receive every three months from a doctor

5. The monthly birth control ring

6. The skin patch

Hormonal birth control methods work by using synthetic hormones to stop your body from ovulating each month. If you take a form of hormonal birth control, it’s not uncommon to notice spotting between periods.

However, not all birth controls are created equal when it comes to spotting. The most likely ones to cause intermenstrual bleeding are:

1. Low-dose birth control pills

2. IUDs

3. Implants

4. The 3-month shot

These forms of birth control contain 10 to 20 micrograms of estrogen — significantly less than other kinds of birth control containing 30 to 50 micrograms. (Other types of birth control, like the progestin-only “mini pill,” contain no estrogen).

Many people who take low-dose birth control notice fewer unpleasant side effects overall (ahem — we’re looking at you, sore breasts and random unannounced headaches). However, with low-dose birth control, you may also note spotting or bleeding between periods that usually subsides after the first few months.

Some individuals may be more prone to spotting than others, including people who:

1. Don’t take their birth control regularly

2. Smoke cigarettes

3. Use emergency contraception in addition to taking birth control

4. Take a continuous dose of their pills or vaginal ring to avoid having a period

medical conditions

Birth control isn’t the only reason you might notice spotting in your underwear. Some medical conditions can have an impact on whether you have spotting between periods, especially if they affect your hormones.

If you have one of the following conditions, it might explain any (seemingly inexplicable) spotting:

1. Thyroid disease – Located at the base of your neck, the thyroid gland handles many essential functions, like burning calories and controlling your menstrual cycle. If your body is making too much of the thyroid hormone (hyperthyroidism) or too little (hypothyroidism), it may increase your chances of irregular uterine bleeding.

2. Polycystic Ovarian Syndrome (PCOS) – PCOS occurs when there’s a reproductive hormonal imbalance in your body. This can affect your ovaries and inhibit their ability to release an egg when it’s time for ovulation. Because of this, some people experience irregular periods, which you might notice as spotting.

3. Perimenopause – The major (and sometimes challenging) time in a person’s life that leads up to menopause is also known as perimenopause. During this time, your body continues to make estrogen while there’s slow and low progesterone production. Because of the ever-changing levels of hormones, you may notice more severe PMS-like symptoms than usual, like mood swings, hot flashes, and irregular periods.

infections

Have you noticed any abnormal discharge along with your spotting? Do you notice dark brown discharge instead of period blood? If so, the intermenstrual bleeding may be because of an underlying infection. Of course, that’s not the only symptom associated with infections. Below, we’ve included a list of infections (and their symptoms) that could be the cause of your spotting.

vaginitis

Vaginitis is an inflammation of the vagina, usually caused by an imbalance of bacteria or infection in the vagina. In addition to spotting between periods, you may also notice:

1. Vaginal itching

2. Discomfort when you pee

3. Changes in vaginal discharge, including its color, amount, or smell

There are two main types of vaginitis, including:

1. Bacterial vaginosis – This type of vaginitis is usually accompanied by an unpleasant fishy odor, especially after sex.

2. Yeast infection – In addition to itchiness around the vagina, a yeast infection often causes a thick discharge that sometimes has a cottage cheese-like appearance.

sexually transmitted infections

Trichomoniasis, while often associated with many of the typical vaginitis symptoms, isn’t the only STI that can cause spotting between periods. The following STIs can also cause occasional bleeding:

1. Gonorrhea

2. Chlamydia

All three share similar symptoms, like:

1. Painful urination

2. Increased vaginal discharge

3. Vaginal irritation (which can cause pain during sexual intercourse)

pelvic inflammatory disease (PID)

PID usually occurs when sexually transmitted bacteria have traveled upward to your reproductive organs. This can cause pain in your lower abdomen and pelvis. While some people who have PID don’t notice any symptoms, others observe a combination of the following:

1. A change in vaginal discharge that may have an odor

2. Unusual bleeding that occurs after sex or between periods

3. Pain during sex

4. Fever

5. Painful urination

If you believe you have an infection, schedule an appointment with your OBGYN to determine the cause of the bleeding and other symptoms. If you do have an infection, they’ll create a treatment plan to ease your symptoms and get rid of the infection.

pregnancy

During pregnancy, periods usually stop. But spotting or heavy bleeding can occur after your last period, possibly before you know you're pregnant. If you're experiencing spotting a week after your period and suspect pregnancy, here's what might be happening.

1. Implantation Bleeding: Spotting can occur during early pregnancy due to implantation bleeding. This happens when a fertilized egg attaches itself to the uterus lining. It's generally lighter than a regular period and might show up around when your next period is due. Sometimes, it's easy to confuse implantation bleeding with a light period, so if you suspect pregnancy, consider taking a pregnancy test.

2. Miscarriage: Spotting could also be a sign of a miscarriage, especially in the early stages of pregnancy. If you're experiencing heavy bleeding, severe abdominal pain, or passing blood clots, seek medical advice immediately.

Ectopic Pregnancy: Another serious condition associated with spotting is an ectopic pregnancy, where the fertilized egg implants itself outside the uterus, typically in the fallopian tubes. This can cause vaginal bleeding, often accompanied by severe abdominal pain, shoulder pain, and lightheadedness. If you experience these symptoms, seek emergency medical care.

other causes of post-period spotting

Birth control, hormonal disorders, and infections aren’t the only reasons you could be experiencing unexplained spotting in the middle of your monthly cycle. There are other potential medical conditions and explanations to consider as well, including:

1. Endometriosis – Endometriosis occurs when the tissue that normally lines the uterus grows outside of it. Sometimes that tissue forms cysts and scar tissue on your reproductive organs, which can cause severe pain and irregular bleeding between periods.

2. Uterine fibroids – Also known as leiomyomas, uterine fibroids are noncancerous growths that form on the uterus. They’re more likely to crop up during your reproductive years. While some people don’t have symptoms, others notice heavy bleeding during their periods, abnormal uterine bleeding between periods, and back and pelvic pain.

3. Medications – There are a handful of medications that can cause spotting between menstrual cycles, like anticoagulants, corticosteroids, antidepressants, and antipsychotics.

4. Gynecological procedures – If you happen to go to the gynecologist for your annual checkup and they tell you it’s time for a pap smear, you might be surprised to find some light spotting after the procedure. It’s completely normal and goes away on its own in a day or two.

how to treat your spotting

If you’re not on your period and you’re experiencing bleeding, you may begin to wonder if you should feel concerned. While it’s often natural and nothing to worry about, it may be time to schedule an appointment with your gynecologist to get confirmation.

In the meantime, you can keep a running record of your symptoms to share with your physician at the visit. If you think of any questions to ask, you can write them down or keep them in the notes section of your phone and bring them with you as well.

During the appointment, your healthcare provider will ask you a series of questions and ask you to describe your symptoms. Then, they’ll likely perform a physical exam and pelvic exam.

Depending on their findings, they may also order one or more of the following tests to narrow down the cause of the bleeding:

1. Pap smear

2. Urinalysis

3. Thyroid functioning tests

4. Complete blood count

5. Pregnancy test

6. Magnetic resonance imaging (MRI)

7. Ultrasound

8. Hysteroscopy

After your physician diagnoses the reason behind the spotting, they’ll devise a treatment plan (if necessary) to decrease the bleeding and other symptoms. Depending on your diagnosis, they may recommend a variety of treatment options, such as:

1. A change in birth control methods

2. Medication that stops the flow of your period and helps to shrink uterine fibroids

3. Antibiotics, if the bleeding is caused by an infection

4. Non-steroidal anti-inflammatory drugs (NSAIDs), (aka ibuprofen) to control occasional heavy bleeding

Whether you’re on your period or you’re experiencing spotting between menstrual cycles, vaginal bleeding is a part of life. But if you notice spotting or abnormal bleeding during a time you normally wouldn’t, take care of yourself by contacting your physician to get to the root of the problem.

find your period groove with Thinx

When it’s time for your period to make its next grand entrance, give yourself grace (and free rein) to enjoy the little things in life. Take out that bag of chocolates you hid from your roommate and grab your comfiest pair of Thinx underwear to make your bleeding days that much cozier.

Thinx look and feel like normal undies, but they offer built-in period protection so you can conquer each day of your period — whether “conquering” means signing off on a big work project or vanquishing that last episode of your latest favorite streaming series.

From Boyshort to the classic Hiphugger, browse our collection to find the perfect fit for you and your flow.

At Thinx, we strive to provide our readers with the most up-to-date, objective, and research-based information. Our content is crafted by experienced contributors who ground their work in research and data. All information has been fact-checked and extensively reviewed by our team of medical professionals to ensure content is accurate. Articles contain trusted third-party sources that are either directly linked within the text or listed at the bottom to lead readers to the original source.

sources:

ACOG. What You Should Know About Breakthrough Bleeding With Birth Control. https://www.acog.org/womens-health/experts-and-stories/the-latest/what-you-should-know-about-breakthrough-bleeding-with-birth-control 

Planned Parenthood. Birth Control Pill. https://www.plannedparenthood.org/learn/birth-control/birth-control-pill 

Planned Parenthood. What Are the Disadvantages of the Pill? https://www.plannedparenthood.org/learn/birth-control/birth-control-pill/what-are-the-disadvantages-of-the-pill 

ACOG. What You Should Know About Breakthrough Bleeding With Birth Control. https://www.acog.org/womens-health/experts-

NIH. Thyroid Dysfunction in Patients with Abnormal Uterine Bleeding in a Tertiary Care Hospital: A Descriptive Cross-sectional Study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7654461/ 

Women’s Health. Polycystic Ovarian Syndrome.  https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome 

John Hopkins Medicine. Perimenopause. https://www.hopkinsmedicine.org/health/conditions-and-diseases/perimenopause 

Mayo Clinic. Vaginitis. https://www.mayoclinic.org/diseases-conditions/vaginitis/symptoms-causes/syc-20354707 

Mayo Clinic. Vaginal Bleeding. https://www.mayoclinic.org/symptoms/vaginal-bleeding/basics/causes/sym-20050756 

Mayo Clinic. Pelvic Inflammatory Disease (PID). https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594 

Mayo Clinic. Endometriosis.  https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656 

NIH. Uterine Leiomyomata.

https://www.ncbi.nlm.nih.gov/books/NBK546680/ 

The Society of Obstetricians and Gynaecologists of Canada. Abnormal Pain and Menstrual Bleeding. https://www.yourperiod.ca/abnormal-pain-and-menstrual-bleeding/heavy-menstrual-bleeding/medications-that-cause-heavy-menstrual-bleeding/ 

Cleveland Clinic. Vaginal Bleeding. https://my.clevelandclinic.org/health/symptoms/17899-vaginal-bleeding 

by Team Thinx