Q: What are the possible causes of spotting?

A: There are many possible reasons for spotting, which can best be assessed by an examination by your doctor:

  • Anovulation (unopposed estrogen)
  • Ovulation bleeding
  • Low progesterone: Shortened or prolonged corpus luteum life span; abnormal relative ratio of estrogen to progesterone
  • Implantation bleeding
  • Cervical infection
  • Pregnancy (intrauterine or ectopic)
  • Endometrial polyp
  • Spontaneous abortion (miscarriage)
  • Beginning or stopping hormones (for example, oral contraceptives, progesterone)
  • Stress
  • IUDs
  • Trauma or injury to the vagina or cervix
  • Cancer (vagina, cervix, endometrium, ovary)
  • Certain drugs (for example, anticoagulants)
  • Vaginal dryness
  • After gynecological procedures (HSG, laparoscopy, biopsy, D&C, cervical cauterization)