Anytime you experience abdominal pain with vaginal spotting, there is a good chance the cause is related to your reproductive system. Vaginal spotting most often comes from the uterus, although bleeding from the cervix or vagina could also cause spotting. Many conditions -- some serious, some not -- can cause abdominal pain and spotting. Call your doctor if you have concerns about these symptoms.
Menstrual Cycle Causes
Some women experience abdominal pain, typically on one side, at the time of ovulation. This type of pain, called mittelschmerz, is sometimes accompanied by light spotting and is not dangerous. Mittelschmerz normally lasts just a day or two. You might also have cramping or abdominal pain accompanied by spotting for a day or two before your period starts.
Some women develop cysts within the ovary. While many ovarian cysts cause no symptoms, larger cysts may cause abdominal pain along with spotting. Rupture of an ovarian cyst can also cause pain, spotting and bleeding in the abdomen. In rare cases, a large cyst can cause twisting of the ovary, cutting off its blood supply and causing severe pain. Call your doctor if you experience severe pain and spotting.
Endometriosis and Fibroids
Endometriosis is a chronic condition in which uterine tissue grows outside the uterus. Abdominal pain accompanied by spotting or heavy bleeding can occur. Endometriosis may interfere with getting pregnant and cause scar tissue formation within the pelvis. Uterine fibroids -- noncancerous growths of the uterus -- can also cause spotting and abdominal pain.
Some of the most potentially serious causes of abdominal pain and spotting occur during early pregnancy. A threatened miscarriage can cause these symptoms. An ectopic pregnancy -- which develops outside the uterus, usually in the fallopian tube -- is another possible cause. Ectopic pregnancy can lead to rupture of the fallopian tube, causing severe and potentially fatal blood loss. According to the December 2012 text "Ectopic Pregnancy and Miscarriage," 64 percent of women with an ectopic pregnancy experience vaginal bleeding and 93 percent have abdominal or pelvic pain. A less serious cause of early pregnancy bleeding occurs when the embryo first begins to burrow into the uterine lining, sometimes causing spotting and cramping around the time of an expected period. Call your doctor immediately if you may be pregnant and experience abdominal pain and spotting that lasts more than a day.
Any vaginal bleeding after menopause merits immediate medical attention. The most serious cause of vaginal bleeding at this time is uterine cancer. Approximately 90 percent of women with uterine cancer -- also called endometrial cancer -- have abnormal vaginal bleeding or discharge, according to a November 2009 "American Family Physician" article. Uterine cancer can, but does not always, cause abdominal pain. Postmenopausal women sometimes experience pelvic pain or pain during intercourse, which may be followed by light spotting. This spotting is typically due to slight trauma to the vaginal lining, which becomes thin after menopause.
Reviewed by: Tina M. St. John, M.D.