Why Do I Get Spotting or Brown Spots in Between Periods?
Spotting or brown spots between periods is a common concern many women experience at some point in their lives. While often harmless, spotting may sometimes signal underlying conditions that require attention, such as infections, fibroids, or hormonal imbalances. Traditional Chinese Medicine (TCM) offers a holistic approach to understanding and managing spotting by addressing the root causes, such as Damp-heat, Kidney Yin Deficiency, or Blood Stasis. In this article, let’s explore the causes, symptoms, and TCM treatments to support your reproductive health.
Causes for Spotting
Spotting or brown spots before a period can be caused by several factors, most of which are generally not a cause for concern. Here are some common reasons:
Hormonal Changes: The menstrual cycle is regulated by hormones, and fluctuations can cause spotting. In particular, lower levels of progesterone can lead to early shedding of the uterine lining, resulting in spotting.
Ovulation: Some women experience spotting during ovulation, which occurs roughly in the middle of the menstrual cycle. This is due to the release of the egg from the ovary and the associated hormonal changes.
Implantation Bleeding: If you are sexually active, spotting could be a sign of implantation bleeding, which occurs when an embryo attaches to the lining of the uterus. This usually happens about 10-14 days after conception.
Birth Control: Hormonal contraceptives, such as birth control pills, patches, or intrauterine devices (IUDs), can cause spotting, especially when you first start using them or if you miss a dose.
Perimenopause: Women approaching menopause may experience irregular periods and spotting due to fluctuating hormone levels.
Stress and Lifestyle Factors: High levels of stress, significant weight changes, and intense exercise can disrupt the normal menstrual cycle and cause spotting.
Infections or Medical Conditions: Infections such as pelvic inflammatory disease (PID) or sexually transmitted infections (STIs) can cause spotting. Other medical conditions like polycystic ovary syndrome (PCOS), fibroids, or thyroid disorders can also be factors.
Cervical Changes: Changes in the cervix, such as inflammation (cervicitis), polyps, or abnormal cells, can lead to spotting.
When Should You See a Doctor?
Spotting between periods is usually nothing to be worried about, as many women experience that at some point. However, should you have spotting accompanied by any of the following symptoms or if the symptoms gradually worsen, make an appointment to see a doctor immediately.
Severe pain in the lower abdomen
Fever
Light-headedness and fainting
Pale skin and loss of colour in the lips
TCM Approaches for Managing Spotting in Between Periods
In Traditional Chinese Medicine (TCM), spotting in between periods is known as 经间期出血(Jing Jian Qi Chu Xue). According to TCM classification, this kind of spotting falls into three patterns of disharmony: Damp-heat, Kidney Yin Deficiency, Blood Stasis etc." This kind of bleeding between two menstrual periods normally occurs around the 12th to 16th day of a typical menstrual cycle. The bleeding typically lasts for 2-3 days and may be accompanied by backache and distention on one or both sides of the lower abdomen. There might also be breast tenderness or increased vaginal discharge that is clear and egg-white-like or mixed with a bit of blood.
Herbal Medicine
The 3 patterns of disharmony mentioned above can be treated with herbs and formulae that allow clearance of Damp-heat, tonification of Kidney Yin and removal of Blood Stasis, respectively. These formulae include: 清肝止淋汤加减 Modified - Qing Gan Zhi Lin decoction (M-QGZL) for Damp-heat, 加减一阴煎 Jia Jian Yi Yin Jian (JJYYJ) for Kidney Yin and 逐瘀止血汤 Zhu Yu Zhi Xue decoction (ZYZX) for Blood Stasis. Herbs in M-QGZL include 当归 Dang Gui 生地 Sheng Di 牡丹皮 Mu Dan Pi 黄柏 Huang Bai 牛膝 Niu Xi etc. that help to not only nourish and cool blood but also clear Damp-heat, an energetic pathogen that commonly plagues the middle and lower portions of the abdomen. Correspondingly, herbs like 熟地黄 Shou Di Huang, 白芍 Bai Shao, 知母 Zhi Mu in JJYYJ and 大黄 Da Huang, 桃仁 Tao Ren in ZYZX help nourish Kidney Yin and clear Blood Stasis respectively.
Oftentimes, a pattern of disharmony might take hold while your body constitution is of a different kind, for example, someone who has a Blood-deficient constitution might be experiencing a Damp-heat pattern of disharmony. This could be caused by a mixture of genetics (accounting for the Blood deficiency) combined with a less than ideal diet high in sweet and spicy food (responsible for causing the Damp-heat pattern of disharmony). A formula that addresses both issues should be prescribed. Thus, taking into account the specific constitution of your body and the pattern of disharmony you are experiencing, a qualified TCM physician can create a personalised formula tailored to you.
Acupuncture and Moxibustion
Acupuncture and moxibustion are commonly used modalities to help regulate menstrual disturbances. The abovementioned patterns of disharmony mentioned above can be treated with TCM and acupuncture through acupoints that assist with the regulation of the period in general in addition to clearing Damp-heat, helping tonification of Kidney Yin and removal of Blood Stasis. General acupoints to use for regulation of the period include: 关元 Guan Yuan 中极 Zhong Ji 三阴交San Yin Jiao. For Damp-heat, 曲池 Qu Chi and 合谷 He Gu are used; for Kidney Yin Deficiency, 太溪 Tai Xi and 气穴 Qi Xue are added; for removal of Blood Stasis, we add 血海 Xue Hai and 外关 Wai Guan.
Additionally, to speed up the removal of Blood Stasis, moxibustion—the burning of mugwort leaves near certain acupoints—can be added. Moxibustion is commonly used in the treatment of gynaecological conditions because it warms the meridians and expels Pathogenic Cold from the body—a constitution often seen in women. Therefore, a person with a Cold constitution and a Blood Stasis pattern would benefit doubly from moxibustion. Since moxibustion involves the use of heat and fire, it is best performed by a professional physician. It is also usually not recommended for Damp-Heat and Kidney Yin Deficiency patterns, as it can exacerbate these conditions. This highlights the importance of an in-person consultation before deciding on treatment.
Who is This Suitable For?
Generally, spotting between periods doesn’t need treatment if it resolves on its own within 1 to 3 days and is not accompanied by any of the symptoms listed above. This is often due to normal fluctuations in hormone levels or physiological responses to birth control mechanisms. However, if the spotting is occurring more frequently and symptoms are severe and increasing in cyclic frequency, a visit to a doctor or physician is necessary.
How Many Sessions Do I Need?
Management of spotting between periods usually takes 1-3 cycles. An in-person consultation with the right Traditional Chinese Medicine practitioners is also a good time for the physician to review your medical history and any other symptoms you might have so as to determine the optimal frequency of visits and treatments based on your current health, diet and lifestyle.
Most importantly, do your research and seek advice from reputable professionals for an elevated healing experience. For more information, visit our website to learn more about our TCM wellness treatments and physicians or to book an appointment. Your well-being is our priority, and we are here to support you on your journey towards better health.
