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Forum Name: Gynecology

Question: Spotting before period


 worried25 - Wed Jan 18, 2006 1:34 am

I am 25 years old and i had an abortion about two years ago. Ever since then, i sometimes experience some spotting a day or two before i start my period. i'll get the spotting one month and it will be fine the next month. However, just recently, i experienced spotting for about 6 days before the regular menstrual flow started. Is this normal or do i need to see a doctor?[/b]
 Dr. Tamer Fouad - Wed Jan 18, 2006 2:30 am

User avatar Hello,

"Spotting" refers to unexpected bleeding that does not require the protection of a sanitary or a tampon.[1]

Normal spotting is what may occur at the very end of your bleeding days. A day or two of spotting after 3 to 5 days of “bleeding” is normal, and just the end of the bleeding period.

In this case you are just "cleaning out" your uterus/vagina. This may be caused from the uterus not completely shedding the products of menstruation, minor vaginal/cervical trauma during intercourse, hormonal imbalances.

The causes of abnormal spotting vary.

One common cause of spotting is low progesterone. It’s the hormone progesterone that helps to maintain the uterine lining for pregnancy and when progesterone level drops, the menstrual cycle occurs. In women who are deficient in progesterone, they will see spotting several days to a week before their cycle is due. This can also cause minor infertility and early miscarriage.

Another reason spotting may occur could be uterine fibroids, which are fairly harmless, but need to be kept an eye on. Endometriosis, birth control pills are a few other reasons spotting may occur. The most harmful reasons for spotting are possible sexually transmitted diseases and some cancers.

It is advisable if you have recurring spotting each month to have your healthcare provider to exam you, just to rule out any possible harmful causes.

References:
==========
1. Thorneycroft IH. Cycle control with oral contraceptives: a review of the literature. Am J Obstet Gynecol 1999;180(2 pt 2):280-7.
 worried25 - Wed Jan 18, 2006 1:16 pm

Thank you for you help bue could you elaborate a little more on the minor infertility and early miscarriage part? Is this something I am at a higher risk for be cause i do want to have children someday.
 Dr. Tamer Fouad - Wed Jan 18, 2006 2:22 pm

User avatar Hello again,

All I am saying is that in some cases that are infertile or have repeated abortions a search for a cause for their infertility may reveal low progesterone levels. This is a minor cause obviously because it is readily correctable.

There is nothing for you to worry about.

Best regards.

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