A bit of spotting between periods is normal now and then, especially for women approaching the age of menopause, or those with irregular periods. But if you don't fit into those categories, bleeding after exercise may be related to your workouts themselves or to an underlying issue.
Heavy Workouts and Spotting After Exercise
A vigorous workout routine may result in anything from spotting between periods, to a lighter or heavier flow at your time of the month, according to Harvard Medical School. Both the exertion itself, as well as resulting weight loss, sometimes cause changes in the hormones that lead to spotting and other period changes.
What, if any, treatment you receive for bleeding after exercise depends on your stage of life. Pre-menopausal women who still wish to keep their heavy workout schedule may be prescribed birth control pills to regulate hormone function.
Hormone replacement therapy may be appropriate for post-menopausal and perimenopausal women. Alternatively, the hormone therapy prescription may be changed if the woman was currently on one type when the spotting after exercise issue began.
Your doctor may also suggest that you modify your workout and diet routines if they've led to excessive weight loss. That doesn't mean you have to stop exercising altogether, but rather modify your routine to see if the bleeding after exercise halts.
Is the “Newbie” Factor at Play?
According to the U.S. Office on Women's Health, bleeding after exercise can happen with women who have previously been somewhat inactive. Throwing yourself back into a routine is commendable but may be a bit of a shock to your system.
In these cases, research suggests that even women who are not taking birth control with hormones, or who are pre-menopausal, can experience hormone changes after becoming active again. Intense exercise may decrease the amount of certain reproductive hormones, which results in either delaying getting your period or spotting between periods.
Read more: I Lost My Period From Weight Loss & Exercise
Watch for Chain Reactions
If spotting is a chronic problem after working out, there may be more than fluctuating hormones causing bleeding after exercise. The American Council on Exercise notes that "over-training" sometimes leads to a chain reaction that starts with chronic fatigue, also referred to as "low energy availability."
When that happens, your body is forced to rob itself of nutrients like fat, protein and carbohydrates. In addition, other nutritional deficiencies may develop from heavy workouts, causing problems such as iron deficiency anemia.
These deficiencies may lead to spotting after exercise, as well as other menstrual cycle anomalies. Your doctor may order blood tests to verify any deficiencies that may be linked to the spotting issue. If so, cutting back on workouts and taking supplements may be the answer.
Track Your Symptoms Carefully
If you detect spotting on the toilet tissue after peeing, it's possible that it comes from a normal phenomenon known as exercise-induced hematuria. In this case, the spotting comes from traces of blood in your urine, rather than from uterine bleeding.
This syndrome is also known as "runner's bladder" and most commonly shows up as blood in the urine after working out. It normally clears up after a day or two and is considered normal, especially in younger women. Your doctor can rule out other causes if the spotting doesn't go away within three days after a heavy workout.
Rule Out Other Causes
It's possible that an underlying condition exists that explains bleeding after exercise. In other words, you would be spotting even without exercising but that the extra contortions made during workouts make the spotting more pronounced. Potential causes of unusual menstrual activity include:
- Fibroids or polyps can appear on the vulva, vagina or cervix. These benign growths are especially common for women in their 40s.
- Polycystic ovary syndrome can also cause breakthrough bleeding. You might also notice changes like thinning hair on your scalp but more hair on your face and body.
- Thickened uterine lining is not unusual during certain life phases. Although hormonal changes during menopause and perimenopause can cause the uterine lining to thicken, and sometimes cause spotting as a result, it should still be reported to your doctor.
- Uterine or cervical cancer is a rare but potential cause of spotting after exercise or other times when you aren't having your regular period. It's just one more reason to visit your doctor and rule out this possibility.
Other causes of unusual menstrual activity such as spotting include thyroid issues, stress and side effects from medication. It's always a good idea to ask your doctor about any spotting after exercise, especially if the problem is persistent.
Read more: 7 Tips to Get Fit Without Going to the Gym
- Mayo Clinic: "Vaginal Bleeding"
- Harvard Medical School: "Dysfunctional Uterine Bleeding"
- U.S. Office on Women's Health: "Physical Activity and Your Menstrual Cycle"
- U.S. National Library of Medicine: "The Effect of Physical Activity Across the Menstrual Cycle"
- American Council on Exercise: "9 Signs of Overtraining to Look Out For"
- U.S. National Library of Medicine: "Post Exertional Hematuria"
- Cleveland Clinic: "Abnormal Uterine Bleeding"
- Women to Women: Irregular Periods