The two terms are differentiated based on the volume of blood discharged through the vagina in a female. During spotting the woman will observe a pink or reddish tinge on her underwear. On the other hand bleeding is heavy and lasts for 2-4 days. Spotting and vaginal bleeding may occur due to a variety of causes. Let us understand the difference between the two and what may be their underlying cause.

Spotting

A negligible amount of blood is discharged through the vagina in droplets. The amount is so less that it just stains the under wear. It is irregular and can be dark brown or pink in colour. There is no need to use pads or tampons as the droplets are absorbed by the underwear cloth. Spotting can occur due to various reasons.

This may happen between two menstrual cycles and can indicate pregnancy or some other medical condition. It may also occur when the fertilized zygote is transplanted onto the uterine lining. This is known as implantation spotting/bleed. The implantation bleed is light and is often on and off type. It remains light for 2-4 days. The discharge is usually brownish or pinkish in colour. This is accompanied by other signs of pregnancy such as nausea, vomiting etc.

In case the woman is pregnant and she experiences spotting, it may or may not indicate trouble in the pregnancy. Women may experience spotting during their first trimester. It is completely harmless in most cases. In case the spotting increases it might point towards threatened abortion, ectopic pregnancy, placental separation or a miscarriage and the woman should be rushed to the gynaecologist.

Spotting may be seen in women who are on birth control pills. It can occur when they miss a dose. Ovulation bleed or spotting occurs around the 10-16th day of the menstrual cycle when the ovum is discharged into the fallopian tube. This is a normal phenomenon. A female suffering from polycystic ovarian syndrome may also have episodes of spotting due to hormonal imbalance.

Some women also report of spotting just after an intercourse. This may occur due to injury to the lining of the cervix.

Bleeding

Blood lost through the vagina during normal menstrual cycle is known as bleeding. It is heavier than spotting and lasts for around 3-4 days. The flow might be less initially but gradually increases before it stops. This is a good way to differentiate it from spotting which always remains light. Menstrual flow requires the use of sanitary pads or tampons. The menstrual bleed is regular and recurs after a fixed number of days in a cycle as opposed to spotting which is sporadic. For some it may occur after every 21 days and for some it may occur after 35 days also. The average menstrual cycle is of 28 days.

At the end of each cycle the endometrial lining that had thickened in anticipation of a pregnancy is shed. This loss of tissue and blood at the end of each cycle is known as menstrual bleed. The woman feels certain premenstrual symptoms like bloating, abdominal cramps, headache, nausea, fatigue etc. just prior to the beginning of the menstrual flow. The symptoms let up once the flow starts. Cramps may precede spotting but are less severe.

There are many other causes of vaginal bleeding. If there is a heavy amount of blood flow in the middle of the cycle it can indicate uterine fibroids or pelvic infection/pelvic inflammatory disease. Women who have got an intrauterine device implanted may experience more than usual bleeding during their menses.

To summarise the difference between spotting and bleeding is based on the variation in the amount of blood lost. There is minimal blood staining during spotting which lasts for a few hours to days whereas bleeding is heavy and lasts longer.

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