Spotting

The term spotting refers to light, irregular bleeding that is usually characterized by a brown or dark red color, often resembling prune juice. Spotting is noticeable, but it is not heavy enough to soak a tampon or pad. The consistency of the bleeding tends to be rather ‘greasy’. Spotting usually does not last longer than 1 or 2 days.

Causes of spotting can be many and varied. Some possible causes of spotting are:

• Hormonal imbalances: Your period is a fantastic indicator of your fertility status and your hormonal health.
• Ovulation: If your body releases an egg during your menstrual cycle, you may experience spotting.
• Early pregnancy: You may experience spotting when the fertilized egg cell implants in the lining of the uterus. This is often referred to as implantation bleeding. 
• Hormonal fluctuations during puberty: Your first period may be rather light and spotting may occur.
• Hormonal changes during menopause: During the years of transition to menopause, spotting may occur.
• Polyps: Benign growths in the uterus can cause spotting as well as irregular cycles and pain.
• Smoking: Women who smoke are more likely to experience spotting, according to studies.
• Sexually transmitted infections: Gonorrhea, in particular, can cause spotting.
• Hormonal contraception: Can cause spotting, especially when taken for the first time.
• Polycystic ovary syndrome (PCOS): A hormonal imbalance that can cause spotting.
• Stress: Both psychological and physical stress can affect the menstrual cycle and lead to spotting.
• Cancer: Certain cancers of the reproductive system can cause spotting.
• Trauma: Rough sex, sexual abuse, or rape can cause spotting.

There are other possible causes of spotting. If you are concerned or your bleeding seems unusual, painful, or is accompanied by worrisome discharge, please make sure to contact your doctor.

Ovulation bleeding is exactly what it sounds like: light vaginal bleeding that occurs when you ovulate. While there are many possible causes for bleeding between periods, ovulation bleeding actually doesn’t seem to be very common. A 2012 study published in the American Journal of Epidemiology suggests that only about 2.8% of healthy young women experience bleeding at this point in their cycle – lasting only about a day.

The color, consistency, and length of your period, as well as the time span between periods, can help you better understand underlying health issues. If you notice brown spotting in the days before your period actually starts, it may indicate low progesterone levels. Low progesterone levels can be a risk factor for infertility and miscarriage. Spotting before your period is usually not a cause for concern right away. If you experience spotting that lasts longer than a few months or seems concerning, we recommend that you see a doctor.

 

It is also advisable to see a doctor if spotting is accompanied by any of the following symptoms:

• an unusual odor
• vaginal irritation and/or discomfort
• discharge that contains blood or looks like cottage cheese
• unexplained fever or fatigue

In rare cases, spotting before your period can also be a symptom of cervical cancer. Other symptoms of cervical cancer may be:

• bleeding that is heavier or longer than usual
• bleeding after intercourse
• vaginal bleeding after menopause
• pain or discomfort during intercourse
• unusual vaginal discharge

People with symptoms of cervical cancer should see a doctor or gynecologist, who can perform a Pap smear to check the cervix for abnormal cells.

A very light period can sometimes resemble spotting and vice versa. The two factors that can be used to determine whether you’re experiencing a period or spotting are the duration and volume of your bleeding. A healthy period usually lasts about 4 days or a little longer, while spotting should only last 1 or 2 days. During a period, there is usually enough blood to soak a tampon or pad. Menstrual blood is also usually cranberry red, while spotting is usually dark red or brownish.

If your period is due and you’re experiencing spotting instead, it could be a sign you’re pregnant. This spotting is often called implantation bleeding because doctors believe it occurs when a fertilized egg implants in the lining of the uterus. Implantation bleeding usually occurs 1 to 2 weeks after fertilization, around the time menstruation would usually begin. Although implantation bleeding is usually lighter than menstrual bleeding, some women may mistake it for a very light period. However, please note that missed periods or light bleeding can also occur due to stress or other health issues.

The birth control pill is a form of hormonal contraception that (in most cases) prevents ovulation and makes conditions in the body less favorable for possible fertilization. The pill contains synthetic hormones that effectively put a woman’s natural menstrual cycle into ‘deep sleep’ when taken. When you start taking the pill, you may experience spotting before your period during the first few months. This spotting is also known as breakthrough bleeding and is a sign that the body is adjusting to the artificial hormones. Spotting can also occur if you forget to take the pill or take it later than usual.

First of all: What does the term TCM mean = “Traditional Chinese Medicine”? 

 

TCM is a holistic medical science that developed in China more than 3000 years ago. At that time, the medical approach was already preventive – that means: the main goal was the avoidance of disease. A Chinese doctor at that time only received money from his patients as long as they were healthy.

 

How does TCM define spotting?

 

The basic idea of TCM is to keep Yin and Yang in balance. You’ve probably heard these terms before.

 

Yang (white) stands for the male part, for warmth, dynamic, movement, as well as the day. All male hormones fall into this category. The time of Yang is from midnight to noon. 

Assigned to Yang is ‘Qi’, which can also be called life energy. Qi should always be in motion, according to TCM.

 

Yin (black) corresponds to the female part, substances such as blood, saliva, sweat, lymph, breast milk, and bone marrow. Yin also includes all female hormones. Yin is directed inward. It stands for purification, rest, protection and preservation, and the night (=rest). The time of Yin begins in the early afternoon and ends around midnight. 

From the TCM point of view, a “normal” period should begin without previous spotting and end without spotting.

 

If there is an imbalance of Qi = Yang and Blood = Yin, this affects the energy channels (= meridians) in the body. You can imagine these energy pathways like different highways in your body, which run from bottom to top and cross each other. If there are problems on one highway, it will inevitably affect the other highways at some point. 

Often TCM refers to terms such as “heart, kidney, liver, stomach, spleen is weakened” and so on. It is important to know that this terminology NEVER refers to the organ from a Western medical point of view, but always to the functional circuit of this organ – and therefore to the highway and everything that is related to it. 

 

What can be the causes of spotting? 

 

Hormonal changes during puberty, menopause or hormonal contraceptives such as the pill can cause spotting. So can emotionally stressful times or situations. If spotting occurs once, they are usually not a cause for concern.

 

The most important causes of spotting from the TCM point of view

 

Spotting around ovulation

 

According to TCM, Kidney yin and Kidney yang control ovulation. All hormones are assigned to the Kidney functional circuit. Spotting can occur when the hormonal transition from Yin to Yang begins during ovulation. Spotting at this time may also indicate a malfunction of the Kidney energy pathway. 

 

Spotting before or after the period

 

The body’s blood is formed from food with the help of the Spleen meridian. The Spleen meridian is virtually our digestion and utilization center, distributing good food for all necessary metabolic processes in the body and providing all “bad” food for elimination. If there is a lack of good food, it is difficult to produce blood sufficiently. In this case, spotting often occurs after menstruation. 

In addition, the spleen has the task of holding the organs in place. If this holding function is weakened due to a Spleen Qi deficiency, spotting may occur before the period. This is because the weakened uterine muscle cannot ‘hold’ the blood long enough.

 

Spotting instead of periods

 

If the Spleen Qi is already in poor condition for a long period of time, it cannot produce enough blood, and this leads to a ‘blood deficiency’ in the medium to long term. As a result, the period can be completely absent, and only light spotting occurs, appearing light red in color.

 

What are the causes of Qi deficiency and possibly later blood deficiency?

 

– Chronic Qi deficiency of heart, lungs and kidneys

– Increased mental and physical exertion

– Persistent worries

– ‘Wrong’ diet

– Chronic and debilitating diseases

– Traumatic experiences

– Sexual abuse/rape

– Surgical interventions

– Severe blood loss during childbirth

– Miscarriage/abortion

– Sterilization

 

Improper nutrition is the most common cause of Spleen Qi deficiency!

 

“Warming up” the uterus is an important step in this symptomatology. This works best with warming foods in the form of rice porridge, soups, stews, especially bone broth and slow-cooked meats and eggs, as well as plenty of legumes, and warm drinks such as Yogi tea. Eating cold foods and drinks – especially right before your period – will further cool down your uterus.

 

Avoid meals consisting of bread, dairy products, raw foods and anything highly processed, as well as frozen and microwave foods. Diets, fasting cures and vegan and vegetarian diets can also damage your Spleen Qi.

 

Spotting during the period or between two cycles

 

1st cause: Damp heat

 

The spleen is weakened by a ‘wrong’ diet – especially in combination with persistent stress. Toxins, which are normally expelled by the body, are deposited in the connective tissue and in the vessels. In TCM this is called “pathogenic dampness” (=mucus/sludge). Dampness tends to move downward like water. Therefore, many problems related to ‘dampness’ have to do with the lower part of the body. Dampness combined with internal heat pushes the blood in the uterus outward.

 

From a nutritional standpoint, the important thing here is to avoid excessive alcohol and fatty and sweet foods. Sugar in general and all dairy products, meals consisting of bread as well as hot spices.

 

Cooked, easily digestible foods and all fresh herbs and bitter foods and spices such as sage, turmeric, celery, and dandelion are recommended.

 

2nd cause: blood stasis (=stagnation)

 

– Occasionally only spotting is experienced, instead of menstruation. –

 

Blood stasis occurs when blood cannot circulate smoothly in the body. Stasis can be caused by cold or heat in the body – often Liver Qi stagnation precedes stasis. Stagnation causes the blood flow to become obstructed or stagnant. Cysts or fibroids in the uterus are usually a sign of blood stasis. In this case, spotting appears dark red, purple or brownish. 

 

What can be the causes of blood stagnation?

 

– Acute and chronic diseases

– Liver Qi stagnation

– Qi deficiency

– Coldness in the abdomen

– mucus/slag accumulation = pathogenic dampness

– Blood deficiency due to ‘wrong’ diet, overwork, stress

– Damp heat in the body due to ‘wrong’ nutrition, being overworked, stress

– External pathogenic factors (viruses, bacteria)

– Emotional stress

– Operations such as thyroid surgery, appendix, cesarean section

– ‘Wrong’ diet

– Stress

– Blood loss due to surgery, accidents, childbirth

 

For cold stagnation, follow the dietary recommendations for “Spleen Qi Deficiency” earlier in the article. Slightly hot spices and foods support the movement of Qi and Blood.

 

For heat stagnation, follow the dietary recommendations for “damp heat.”

 

In addition to proper nutrition, you should always find ways to de-stress and relax in your everyday life. This can be a walk in nature, yoga, or qi gong. Any kind of movement activates the Qi. Meditation relaxes the mind and nourishes the blood.  

 

Spotting that is present for more than 3 months should always be examined by a specialist. Herbal therapy and/or acupuncture are recommended. Please seek out an experienced TCM therapist for this. However, always remember that acupuncture and herbs are only beneficial if you change your diet accordingly.