Out, Damned Spot(ting)

I have a question that I plan to bring up to my OB-GYN at my next appointment, but I’m freaking out now and can’t wait until May. About six months ago, I started spotting between periods. It was only once and it only lasted for a couple days–my sister-in-law walked me through it and I didn’t think anything of it. This month, my period had been over for about a week and boom, here it comes again. This time it took on the shape of a normal flow for me, except in reverse. It started out light and then it progressed over three days to a heavy flow, clots and all! I don’t have a history of anything being irregular with me down there, and I don’t have pain or anything odd during sex. I’m currently not on any birth control pills, but I’m planning to talk to my doc about that when I see her in May. Is there any possible explanation you can give me, or shed some general light on spotting, so that I don’t continue this flipping out?

Dr. Kate Answers:

I’m glad you wrote in–because there’s no need to panic. It’s totally normal to skip a period on occasion–or even to “double up” one month. And spotting is even more common. I usually don’t start a workup for patients with irregular bleeding until at least 3 to 6 months of irregularity. Your gyno may test you for STDs (specifically chlamydia and gonorrhea) and hormonal imbalances (specifically thyroid and pituitary disease) just to rule them out. If you haven’t had a recent pap smear, she’ll do one. She may also order a pelvic ultrasound, looking for fibroids and polyps (both benign, but common causes of irregular bleeding). If these are all negative, the irregular bleeding is likely due to randomness or stress, and nothing to be alarmed about.

If the bleeding continues to be irregular, your gyno may talk to you about birth control pills just for regulation. But if you’re not anemic, and other testing is fine, you don’t have to do anything. Let me know if your OB/GYN tells you things that scare you…and until then, try not to worry.