Pre-existing conditions such as stress, fibroids and endometriosis can cause spotting between periods or it could be implantation bleeding. Spotting before a period is not normal and could be an indication of an underlying health condition. Spotting during ovulation can be normal, but a gynecologist must make that determination.
The first thing to determine is whether the bleeding is really coming from the vagina, urethra or rectum. According to WebMD, vaginal bleeding is abnormal if it occurs during pregnancy, outside of a menstrual period, after menopause or before age 9.
Once a woman starts spotting, she should see her gynecologist who will do checks to determine if the bleeding is harmless or is being caused by an underlying condition. Possible reasons for mid-cycle spotting can be a miscarriage, and undiagnosed vaginal infection, polyps, hormonal fluctuations, low thyroid levels, birth control such as IUDs or cancer of the reproductive organs.
A gynecologist considers many factors when trying to diagnose the cause of spotting, including the age of the patient. The list of conditions that would trigger spotting in a 9-year-old girl would differ from the list of possibilities relevant to a menopausal woman. Other factors may include history of pregnancy or miscarriage, previous biopsies or surgeries and family medical history.