Why Am I Spotting?

Two years ago I had issues with spotting. As a woman who observes the laws of Nidda it was something that I noticed right away. While sometimes my period tended to be on the longer side, I never before had issues with spotting between periods. I was certain something was off, I spoke to friends and even a madrichat kallot. Everyone said it was probably stress and nothing to worry about.  But I worried and made an appointment with my OB/GYN. She told me that I should schedule a hysteroscopy, a procedure when the doctor uses a camera to check inside the womb. At the appointment I was told I had an endometrial polyp, a small cluster of cells in the womb that are growing abnormally that can cause spotting and can be removed with an inpatient procedure.

Women who observe the halachot of Nidda are closely attuned to their cycle and any irregularities. There are numerous laws that relate to questions of ketamim spots of various colors that may or may not be considered a period.  While so many of us are vigilant to investigate spotting for its halachic ramifications, I always make sure to discuss that these irregularities may be a sign of a health issue that should be addressed. When keeping this in mind, the halachot of Nidda present an additional benefit, awareness of our cycle which can indicate red flags for health.

It is important to note that most spotting is indeed benign and can be attributed to stress, ovulation, hormonal contraception use or mild illness, so my friends and kallah teacher were right, but sometimes there is more to the story, so it’s always worth it to check things out with your OB/GYN. 

Irregular bleeding refers to any bleeding that happens outside of your regular period. This might include:

• Spotting between periods

• Bleeding after sex

• Heavy or prolonged periods

• Bleeding after menopause

• Bleeding during pregnancy

Sometimes, spotting is completely normal—like during ovulation or when starting a new birth control method. Other times, it may be a sign of a health issue that needs care. Some of the possible causes of spotting are listed below.

Fibroids and Polyps In both of these, tissue is growing in an atypical way in the uterus. This can cause heavy periods, spotting, or bleeding between periods. They’re common and treatable but should be evaluated by a doctor.

Infections Vaginal infections (bacterial, viral, or yeast) can make the tissues more sensitive and prone to bleeding, especially after sex. If the infection spreads to the cervix or uterus, it can cause more serious symptoms.

Endometriosis

This condition occurs when tissue similar to the uterine lining grows outside the uterus. It can cause longer, heavier, or more painful periods, along with irregular bleeding.

Pregnancy

Spotting can happen early in pregnancy—sometimes due to implantation or a hormonal shift. But heavier or ongoing bleeding can signal a problem, like an ectopic pregnancy or miscarriage. Always check with a doctor if you're pregnant and bleeding enough to need a pad.

Menopause and Perimenopause

As women approach menopause, hormone levels fluctuate. This can lead to irregular or skipped periods, spotting, or heavier-than-usual flow. Bleeding after menopause, however, is never normal and should be checked out right away.

Cancer

Although less common, cancers of the cervix or uterus can cause irregular bleeding—especially after sex or after menopause. Early detection is critical, so don’t ignore symptoms.

Reach out to your healthcare provider if you experience:

• Bleeding after menopause

• Bleeding after sex

• Very heavy or long periods

• Bleeding with pain, dizziness, or fever

• Irregular bleeding that lasts for several cycles

You know your body better than anyone else. If something doesn’t feel right, trust your instincts and get it checked out.

Spotting or irregular bleeding can be unsettling, but it’s also a common experience—and often treatable. Whether it's a harmless hormonal shift or a signal your body needs support, you're not alone. Hilchot Nidda gives us a unique opportunity to track your cycle and listening to your body is one of the most empowering things you can do for your health.

If you have questions or concerns, don’t hesitate to reach out to your doctor. Yael Maizels consults for medical device and pharmaceutical companies in all areas of health. She has done research in a number of fields in women's health including menopause, birth control, cervical cancer and personalized oncology. She has taught anatomy and embryology in the Pre-Med department at Ariel University, and has a PhD in developmental and cancer biology.