Light pink blood on toilet paper after urinating pregnant

Implantation bleeding is light spotting that some people may mistake for an early period.

Implantation bleeding occurs when a fertilized egg implants in the uterine lining. The bleeding is usually light and may last a few days.

In this article, we explain what implantation bleeding looks like and how people can distinguish it from menstruation. We also explain when to take a pregnancy test and see a doctor.

Implantation bleeding may initially resemble the start of a menstrual period. However, while menstrual flow will usually get progressively heavier, implantation bleeding will not.

• On a pad: Implantation bleeding is usually light and, therefore, should not soak a pad. However, the bleeding may be enough to be noticeable, and a person may wish to wear a pantyliner.
• When using the toilet: A person may see a small amount of blood in the toilet or on a piece of toilet paper when they use the bathroom.
• On a tampon: Ideally, if a person suspects implantation bleeding, they will not use a tampon. A tampon can introduce bacteria into the vagina, increasing the risk of a vaginal infection. However, if using a tampon, the bleeding should not soak it enough to require multiple changes.

The appearance of implantation bleeding can vary from person to person, but it is usually light pink or a rusty brown.

If a person has very regular periods, and implantation bleeding occurs about 2 weeks after fertilization, the bleeding may initially seem like the start of a period. However, there are some key differences. These include the following:

• In some people, implantation bleeding may occur earlier than an expected period.
• Implantation bleeding does not usually last as long as a period.
• A menstrual period tends to be heavier than implantation bleeding, which is usually light spotting.

If the bleeding persists beyond a few days, it is not likely to be implantation bleeding.

If someone is unsure whether their bleeding is pregnancy-related or a period, they can take a home pregnancy test.

These tests detect the presence of the human chorionic gonadotropin (hCG) hormone. The body starts to make hCG once the fertilized egg has implanted in the uterus. Therefore, the production of this hormone will begin just after the time when implantation bleeding might occur.

While home pregnancy tests have become increasingly sensitive to hCG, waiting until the first day after a missed period is likely to yield a more accurate result.

Learn about how and when to take a pregnancy test here.

Implantation bleeding occurs during the first trimester, usually about 1–2 weeks after a sperm fertilizes an egg.

The following is a typical fertilization cycle timeline:

• A person will usually ovulate (release an egg from the ovary) about 14 days before their next menstrual period starts.
• Once the egg is released, a sperm must fertilize it within 12–24 hours.
• If fertilization does not take place, the cycle will continue, and a period will usually occur in 2 weeks.
• If fertilization does occur, the fertilized egg will remain in the fallopian tube for several days before moving toward the uterus.
• When the fertilized egg reaches the uterus, it can implant into the uterine lining.

There are other potential causes of bleeding in early pregnancy. An estimated 15–25% of people experience some form of bleeding in the first trimester.

Learn more about bleeding in the first trimester here.

Implantation bleeding is not a cause for concern. The bleeding is usually light and does not last very long.

However, other symptoms may indicate other issues, such as an ectopic pregnancy or pregnancy loss. These symptoms include:

• lightheadedness
• shoulder pain
• unexplained stomach or pelvic pain
• vaginal bleeding that persists for several days
• weakness

These symptoms can indicate a potential emergency and require immediate medical attention.

Implantation bleeding is usually shorter and less heavy than menstrual bleeding. If a person is unsure which one they are experiencing, they can wait a few days and then take a pregnancy test.

If at any time during a confirmed pregnancy, the bleeding becomes heavy or accompanies cramping pain, medical attention is necessary.

Spotting is light bleeding that can occur between periods. Many factors may cause spotting, but it is usually not a cause for concern.

When people experience vaginal bleeding at times other than during normal menstruation, doctors refer to this as intermenstrual bleeding. Spotting tends to occur between periods and can happen at any age after puberty.

Spotting is a very light bleed from the vagina. It differs from the light bleeding at the start and end of a period.

Several conditions, infections, and medications can trigger spotting. Although most reasons for spotting are mild, some can be severe.

This article explores the potential causes of spotting, and looks at when a person should see a doctor.

People usually notice they are spotting if they see a small amount of blood on toilet paper after wiping. They may also observe a few drops of blood on their underwear.

If a person is spotting, the amount of blood loss is not enough to cover a panty liner or pad.

Several factors can cause spotting, such as:

Birth control

Some forms of birth control list spotting as a side effect, including

• birth control pills
• birth control skin patches
• birth control implants
• intrauterine devices

Spotting is most common in the first few months of using a new method of hormonal contraception. The bleeding will usually go away without intervention.

Pregnancy

Spotting sometimes occurs during pregnancy. Around 25% of people experience some form of bleeding or spotting when they are pregnant.

During the first trimester, spotting can be due to:

• implantation, when the fertilized egg attaches to the lining of the uterus
• having sex
• hormonal changes
• cervix changes
• genetic testing, such as amniocentesis or chorionic villus sampling

Heavy spotting during pregnancy may indicate pregnancy loss. Other symptoms of pregnancy loss may include:

• abdominal cramping or pain
• fluid, discharge, or tissue passing from the vagina
• vaginal bleeding
• back pain

Heavy spotting can also be a sign of an ectopic pregnancy. Doctors call a pregnancy ectopic when the fetus grows outside of the uterus, usually in the fallopian tube. A person with this condition needs immediate medical attention.

An ectopic pregnancy may cause:

• vaginal bleeding
• abdominal pain on one side
• discomfort when passing urine or stool
• shoulder pain

Spotting or bleeding later in pregnancy can be a sign of going into labor or a complication, and a person should seek medical advice. If the bleeding is heavy, they should go to the delivery hospital immediately.

Menopause and perimenopause

When people stop having periods, doctors refer to this as menopause. This tends to develop at 45–55 years of age.

The years leading up to menopause are known as perimenopause, which can last up to 10 years.

During perimenopause and menopause, hormonal changes can impact the menstrual cycle, resulting in spotting.

Sexually transmitted infections

Some sexually transmitted infections (STIs), including chlamydia and gonorrhea, can trigger vaginal bleeding between periods. STIs can easily spread between sexual partners and lead to severe complications.

Other symptoms of STIs include:

• yellow vaginal discharge
• painful or frequent urination
• discharge from the rectum
• rectal bleeding

People who contract chlamydia or gonorrhea will need to speak to a doctor, who can usually treat these conditions with antibiotics.

Cervical cancer

Sometimes, spotting can indicate cervical cancer, which develops when cancer cells form in the cervix.

Other symptoms of this condition might include:

• bleeding after sex
• bleeding after menopause
• having longer and heavier periods than usual
• pain during sex
• pelvic pain
• swelling in the legs
• difficulty passing urine or stool
• blood in urine

Often, there is nothing to worry about with spotting, and it will go away without treatment. If it persists for a few months or more, a person should speak to a doctor.

During pregnancy, a person who thinks they may have an ectopic pregnancy or are experiencing pregnancy loss should seek immediate medical attention.

People should also seek urgent medical care if they have any bleeding later in pregnancy that does not relate to sex or labor.

Menopause-related spotting tends to stop without intervention. Anyone who finds that menopause or perimenopause symptoms interfere with everyday life should speak to their doctor.

STIs, such as chlamydia and gonorrhea, can lead to severe complications, including infertility. Anyone who believes they might have an STI should contact a doctor for treatment.

Cervical cancer can be life threatening. Those who experience cervical cancer symptoms should see their doctor as soon as possible.

Spotting is a form of vaginal bleeding. It occurs between periods and is so light that it should not cover a panty liner or sanitary pad.

Most people notice spotting as a few drops of blood on their underwear or toilet paper when wiping.

In most cases, spotting should not cause concern. Often, hormonal changes due to birth control, pregnancy, or menopause can trigger it.

Sometimes, particularly in the latter stages of pregnancy, spotting can indicate a complication. In people who are not pregnant, spotting may be a sign of an STI or cervical cancer.

Anyone worried about spotting should speak to a doctor.