Otherwise known as Intermenstrual Bleeding (IMB), spotting is a common occurrence for many women each month. Perhaps you’re spotting a few days before your period…or after your period? Maybe you have a small amount of bleeding mid-cycle around the time of ovulation? Maybe you’re perimenopause and you’re noticing patterns of spotting that were not there before? Let’s take a closer look at some of the explanations as to why this might be happening…
One of the most common causes of IMB is low progesterone. Progesterone is the wonderful hormone that surges after ovulation occurs each month. Without ovulation we don’t make it! It’s super important for very many reasons, one of these being its role in keeping estrogen in check. The lining of the uterus builds up in the first part of the cycle, ready for ovulation and for progesterone to warm, nurture and enrich it. However, if we are lacking in progesterone or if we don’t even ovulate and progesterone is not produced, then the lining can start to come away too early in the form of spotting a few days before your period actually starts.
The best way to support yourself with low levels of progesterone, is to manage and deal with stress. Stress plays a huge factor in our hormonal balance and directly affects the quality of our ovulation (1). Not only do we want to just ‘deal’ with stress, for optimal health, we really need to be finding stillness and having a relationship with this innate quality to support progesterone to be able to do what it needs to do. Keep an eye out for my regularYoga of Stillness programs.
Sometimes stress doesn’t have to be as big as we think. It may not be a huge event that has occurred, a deadline at work or a relationship breakdown. Low levels of high-functioning anxiety can be enough to allow adrenalin and cortisol to take over and progesterone becomes one of the first casualties. So it is well worth finding a way of getting underneath the normalised anxiety, no matter how low grade it may be. You may start by slowing down...and getting a sense of what you need to support yourself in a very real and practical way.
You can get your progesterone tested with a Day 21 (mid luteal phase) test at your GP. This test is assuming that you have a regular cycle say 26-30 days in length. Otherwise you will need to have an idea of when you are ovulating to know when your mid luteal phase is (progesterone peak). Using your fertile signs is a fantastic way to know exactly when you ovulate and using these signs to chart your cycle, can provide some very key information about your levels of progesterone too!
Research has shown that nutritional support can help boost your progesterone. Such as Magnesium to support your nervous system, keeping you calmer and thereby preserving your progesterone (2). Vitamin C is another one, where research has shown to boost progesterone levels (3). Zinc is one of those all-rounders that supports our stress responses, thyroid function and also promotes ovulation thereby regulating our menstrual cycle.
Are there any other reasons for spotting?
Of course, low progesterone is not the only reason you may be spotting.
If you are spotting a few days around the time of ovulation, this can be seen as quite normal given the adjustment being made with estrogen and progesterone – estrogen drops and progesterone hasn’t had a chance to kick in to full gear as yet.
If you are using hormonal contraceptives, such as the pill or an intra-uterine device (Mirena or Copper IUD), spotting is known to occur as a result. This does not happen for all women but something to be aware of if you are using these medications and devices. Be informed with ALL options and treatments to make the right choice for you and your body.
And if you are around 40-45+, you are likely in the stages of perimenopause, at which time your hormones are making some very big adjustments. Generally, this is associated again with the great progesterone crash that starts to happen resulting in unopposed oestrogen. If spotting is consistent, always check in with you medical doctor.
And lastly, spotting between periods may be due to conditions like endometriosis, fibroids or adenomyosis. Conditions where the imbalance of estrogen and progesterone become more significant along with other factors in a woman’s health including inflammation and immune issues. In these cases, bleeding can tend to be much more regular and can sometimes last a week or more prior to the first day of the menstrual cycle. Always ensure you are seeking medical advice and be guided by your trusted health professional.
So here’s a summary of some steps you may want to take –
- Find out when you ovulate
- Get to know your fertile signs
- Take a progesterone "Day 21" test if needed
- Deal with stress & build a relationship with the quality of stillness
- Nutritional supplements if required (check with your health-care provider)
- Learn how to chart to get insight into your progesterone levels (see intro guide to Fertility Awareness)
- See your doctor if you have any concerns about your symptoms
Spotting can be annoying and inconvenient, however it is also yet another way that our body is communicating to us. Be curious and interested in what your body is saying to you. Even the smallest things can be absolute gold in understanding your overall health and well-being.
Love to hear from you! Always welcome your comments and feedback.
1. Sanders K, Bruce N. A prospective study of psychosocial stress and fertility in women. Human Reproduction. 1997;12(10):2324-2329.
2. Parazzini F e. Magnesium in the gynecological practice: a literature review. - PubMed - NCBI [Internet]. Ncbi.nlm.nih.gov. 2020 [cited 21 March 2020]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28392498
3. Henmi H, Endo T, Kitajima Y, Manase K, Hata H, Kudo R. Effects of ascorbic acid supplementation on serum progesterone levels in patients with a luteal phase defect. Fertility and Sterility [Internet]. 2003 [cited 21 March 2020];80(2):459-461. Available from: https://www.fertstert.org/article/S0015-0282(03)00657-5/fulltext
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