Oftentimes, something that’s ultimately pretty harmless is causing this menstrual cycle problem, like a benign uterine or cervical polyp that’s prompting you to bleed between periods. But spotting is also a common sign of pelvic inflammatory disease (PID), which happens when sexually transmitted bacteria from infections like chlamydia and gonorrhea spreads to reproductive organs like your uterus, fallopian tubes, and ovaries. In addition, pelvic inflammatory disease can cause issues like fever, strange vaginal discharge that smells bad, and burning when you pee.
If you have PID, your doctor will first address the STI in question with antibiotics, says the CDC, then treat your partner for an STI if necessary. Pelvic inflammatory disease is a leading cause of chronic pelvic pain and infertility in women, so if you suspect you have it, getting quick treatment is of the essence.
More rarely, spotting in between periods can be a sign of cervical cancer, according to the Mayo Clinic. Various strains of human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer. (It’s important to note that HPV is very common, and most people with the virus never develop cervical cancer or any other type of cancer.) Symptoms of cervical cancer can include watery, bloody discharge that might have a bad odor and pelvic pain, including during intercourse, according to the Mayo Clinic. Even though this likely isn’t your issue, you’ll want to get checked out, just in case. Treatment for cervical cancer may involve a hysterectomy, radiation, or chemotherapy.
6. You have debilitating mood issues before your period.
When your estrogen and progesterone drop before your period, you may experience the typical mood swings that can come with premenstrual syndrome (PMS). (Bear in mind that this may not be as drastic if you’re using hormonal birth control, which keeps your hormones more stable throughout your cycle.)
But if you deal with severe mood swings, irritability, anger, a lack of enjoyment in things you usually enjoy, and other symptoms that affect your life, you may have premenstrual dysphoric disorder (PMDD). PMDD happens when you experience these symptoms in the week before your period, then they start getting better in the first few days of bleeding, and disappear in the weeks after your period. It’s listed in the DSM-5, the most recent version of the Diagnostic and Statistical Manual of Mental Disorders, for good reason: This psychological issue can be devastating.
“If you suspect you have PMDD, the one thing I would encourage is keeping a daily record of the severity of your symptoms,” Dr. Minkin says. If you notice these symptoms only appearing the week before your period, PMDD might be your issue. If you realize you’re constantly dealing with these symptoms and your period just makes them worse, it could be premenstrual exacerbation, which is another way of saying you have a mental illness like depression that gets worse during your period thanks to hormonal changes.
Either way, talking to a doctor may help. If you have PMDD, your doctor may have you take antidepressants in the timeframe when you usually experience symptoms, then stop once your period starts, Dr. Minkin says. (If you have premenstrual exacerbation, they may recommend staying on the antidepressants through the month and potentially upping your dosage in the week before your period.)
Or your doctor may suggest you go on birth control using a synthetic version of progesterone called drospirenone, Dr. Minkin says, like Yaz and Beyaz. These are FDA-approved to treat PMDD. Though experts aren’t sure why they can be so successful in this arena, it may be because drospirenone reduces a person’s response to hormonal fluctuations. It’s also a diuretic, meaning it can flush out liquids that could otherwise cause fluid retention and contribute to things like bloating.
7. You have excruciating migraines before or during your period.
If migraines were even remotely considerate, they’d at least leave you alone when you’re about to get your period. Unfortunately, period migraines are another issue you can add to the list of common period problems.