There are certain maladies or health concerns that are common amongst runners but that are a little uncomfortable to talk about or don’t necessarily fall under the umbrella of “normal” dinner table conversation—bloody nipples, runner’s trots, and black toenails to name a few.
Spotting after running or spotting after exercise is another frequent concern for female runners who have yet to go through menopause. Our big question always becomes, can exercise cause spotting?
Vaginal spotting after exercise can be worrisome, particularly if you are trying to get pregnant or are running while pregnant. However, the good news is that spotting after exercise is generally a relatively innocuous disruption to the menstrual cycle that shouldn’t be particularly concerning.
In this guide, we will discuss the common causes of vaginal spotting after exercise and when vaginal bleeding after exercise is concerning to help you decide if and when you can keep running or should stop and seek medical care.
We will look at:
- What Is Vaginal Spotting?
- Why Am I Experiencing Spotting After Exercise?
- Potential Causes of Spotting After Exercise
- What to Do About Spotting After Exercise
Let’s get started!
What Is Vaginal Spotting?
Spotting refers to any bleeding stemming from the vagina at any time between your normal monthly menstrual period during your menstruation cycle.
Spotting outside of the context of exercise is most common amongst adolescents and women on the cusp of menopause.
Some women experience spotting after running or spotting after exercise in general, particularly if the workout was intense. The vaginal discharge may be bright red, pink, brown, or dark red.
Why Am I Experiencing Spotting After Exercise?
According to The Society of Obstetricians and Gynecologists of Canada, the majority of women experience spotting at some point during their menstruating years, and spotting after exercise is one of the common concerns amongst runners and other female athletes.
Research shows that vigorous training can—and often does—cause menstrual function changes and disruptions. Some women experience spotting after workouts, changes in the flow during their period, delays in periods, and missed periods altogether.
Exercise acts as a physical stressor on the body, and high-intensity exercise, and/or a high volume of exercise, can alter the levels of hormones that regulate the cyclical buildup and shedding of the uterine lining.
Spotting after working out occurs when the normal hormonal signals are disrupted and instead, the hormones signal the uterine lining to shed, or partially shed, prematurely.
This causes bleeding or bloody discharge during the interval between periods when you normally do not bleed.
Most of the time, spotting after exercise occurs when the workout was particularly intense or vigorous, though this is not necessarily the case.
Potential Causes of Spotting After Exercise
The following are some of the more common reasons why you might experience spotting after running or working out:
#1: Hormonal Imbalances
If you are only experiencing spotting after strenuous exercise, but not at other points between your periods, the vaginal spotting is most likely due to hormonal imbalances induced by vigorous physical activity.
Exercise stresses the body and can change energy availability, particularly when coupled with low energy intake (dieting) and/or low body fat levels.
These stressors can alter the production and secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which affect ovulation. Abnormal levels of these hormones can then result in abnormal levels of progesterone and estrogen, which affect the shedding of the uterine lining.
As a result, you may experience spotting after exercising.
Sometimes, spotting can occur after intense exercise or intercourse or just due to irritation or friction on the cervix from vigorous physical activity. In these cases, the spotting is usually lighter and mostly just from cervical tissue than a full shedding of the uterine lining.
#3: Weight Loss
Weight loss, particularly rapid or as a result of severe caloric restriction coupled with vigorous exercise, causes a significant drop in estrogen levels. As a result, the entire menstrual cycle can be disrupted.
Amenorrhea (loss of period) can occur, and spotting after running or working out is one of the early signs of this disruption.
Spotting can be a sign of a complication with pregnancy, such as a miscarriage, ectopic pregnancy, or molar pregnancy.
If you are trying to get pregnant or are currently experiencing spotting after exercise with your pregnancy, it’s crucial that you speak to your healthcare provider as soon as possible.
Consider taking a pregnancy test if you have been experiencing spotting after working out and have missed a period or have other signs of pregnancy.
The physical stress from working out or psychosocial stress from everyday life can both increase levels of cortisol, a stress hormone, in the body.
When cortisol increases, your sex hormones can decrease or become imbalanced, causing menstrual disruptions such as spotting after exercising.
Spotting can be a normal sign of healthy ovulation. If you track your cycle and notice that spotting is only occurring while you ovulate, it’s completely normal physiologic bleeding.
#7: IUD Use
An intrauterine contraceptive device, particularly hormonal IUDs like Mirena and Jaydess can cause spotting, particularly if you’ve had it for less than 3-6 months.
These devices increase progestins, which stimulate the shedding of the uterine lining. It takes several months for the body to adjust to the device and find the right balance of hormones.
Sometimes, the hormonal influence from the IUD is more intensive than your body needs initially, causing premature shedding seen as spotting after exercise or otherwise.
However, if spotting is still routinely occurring after about six months, it’s a good idea to speak with your gynecologist.
The same can be said for starting, stopping, or changing oral contraceptive pills, as these also cause changes to your hormonal profile. Spotting after exercise can occur while your body acclimates to the changes in your medication.
#8: Endometrial or Cervical Polyps
Polyps are abnormal growths that can occur on the endometrium (inner lining of the uterus) or the cervix. They are usually benign (noncancerous), but polyps can affect your flow during your period and can cause spotting.
Spotting after exercise can be a sign that you’re approaching menopause, especially if you’re age 40 or older. Spotting starts to occur as your hormonal levels change, and your periods will become lighter and less frequent.
What to Do About Spotting After Exercise
As can be seen, spotting after running or working out can be due to numerous things. If you’ve ruled out pregnancy, aren’t approaching menopause, and haven’t changed your birth control methods, it’s a good idea to examine your diet and caloric intake.
If you’ve been losing a significant amount of weight or have low body fat already, it is a good idea to speak with your doctor or a sports nutritionist to help you develop a healthy, sustainable diet and exercise plan.
Keeping your body under constant stress can have long-term health implications in terms of fertility, bone density, and more.
So, can exercise cause spotting? It sure can. But when in doubt, seek medical input about your spotting. Fortunately, in most cases, spotting after exercise isn’t a significant cause for concern, but it’s always good to keep your eye on any changes in your body.
If you are looking for some changes to your nutrition, check out our following tips:
Running Nutrition Guide: What To Eat For Runners