Pre Period spotting – what it really means.

Recently I was asked to write about pre period spotting and what it really means.  It’s so important for us to understand that like all symptoms, it is just a gentle nudge from our bodies to look deeper into the underlying issue and spotting at any time of the cycle is no different. But it can tell you a lot.

There are several reasons we might see spotting pre period.  The most common reason I see in the clinic is a decline of progesterone before menstruation.  

In a perfect scenario, progesterone won’t dip until the onset of the period, however what we all should know is that nobody is perfect – in fact, imperfect is the new perfect.  What’s more, the information I share with you here is simply a guide.  

We must then go away with it and apply it to our own unique situation to really gain answers and the truth about ourselves.

In the instances of low hormones, we often see this tapering of progesterone pre period marked by spotting.  If you are a temperature taking kind of gal, you might have noticed in your monthly temperatures this pattern occurring alongside this key symptom.  This is one reason why temperature monitoring can be wonderful.  

That said, I find temperature charting so stressful for so many women it’s best left aside unless you suspect there might be irregularities within your cycle that you can’t decipher with symptoms alone.

The luteal phase (from ovulation through to when the period arrives) is typically a predictable part of the menstrual cycle – which means that if there are differences showing up for a woman each month it should be quite straightforward in working out what is actually going on.  

Progesterone, secreted by the ovaries should be steadily high through this time – it is this action of the ovaries (the corpus luteum to be precise) directly acts on the temperature regulating centres within the brain.  

For this reason, in TCM we like to ensure that temperatures remain high and the womb remains ‘warm’ to keep progesterone levels up.  Many people have heard of the common TCM term ‘cold uterus’ and it is a good way of seeing just how clever the Professors of TCM in times gone by were – they recognised this key element of a healthy menstrual cycle and that a uterus that was ‘cold’ wasn’t preforming adequately.

This is a key element of healthy hormones not limited to women trying to conceive.  Most likely women trying for a baby quickly realise the importance of a strong luteal phase and if care is needed, take action to ensure it’s supported.  

Of course, I’ve made it my mission to reach out to young women at the time when symptoms arise to take action from the start point simply because healing is much easier at the beginning of the journey and your symptoms are showing you the inner picture.  It’s so important to act on them from the get go.

If the corpus luteum can’t carry out its role adequately to continue to secrete progesterone, maintain slightly higher temperature levels to sustain uterine activity, nourish the endometrium and support implantation (should there be a fertilised embryo – and ONLY THEN) and maintain the embryo then this not only should be address but can be done so very easily and successfully.

The other key driver for pre period spotting is the presence of tissue in the uterus and pelvis – be it endometriosis, adenomyosis, fibroids or cysts.  

All unwanted but again all easily treated with the right tools.  The key symptom here is typically pain due to the blockage that the unwelcome growth is creating by way of general pelvic pain, severe period pain or pain with sexual intercourse.  

Sometimes however there are no obvious symptoms.  As a practitioner I will always ask a host of questions if I suspect any of these conditions – ranging from information about the bowels right through to headaches and heart palpitations.  

As a TCM practitioner, the answer to these questions is vital for diagnosis and treatment.  This means a specific tailor made treatment can be made for each patient, never a one size fits all approach.

Say you find yourself suspecting either low hormones or physical blockages – rather than freak out, remember it is simply your body guiding you in the best direction to take moving forward.  

I’ve a few suggestions
and of course, a little trial and error may help get you on your merry way.  Failing that, it’s important to seek advice from somebody who understands hormone health.

+ ‘Warming’ up the uterus is a great step in the right direction if you find yourself facing low hormones, specifically an early decline of progesterone.  You can use warming foods (remember food is medicine and nourishment) by way of congees, soups, stews especially bone broth and slow cooked meats.  Eggs are also fabulous.  Eating cold food right before the period may contribute to the already cold environment and encourage lower temperatures.

+ Applying a heat pack to the lower abdomen post ovulation is also a great way of keeping the activity booming through the uterus.  Some people like to use castor oil packs.  I’m a fan of the good old wheat bag.

+ Often to build progesterone, we must first build oestrogen.  This means supporting your body right through your cycle.  The specific ideas I outline in my book Well and Good gives you a great guide from all corners of your diet and lifestyle.  Factoring in stress, enough sleep, good habits, great vitamin levels and so on is essential for all round wellness.  Of course maintaining good levels of therapeutic fats and protein is also key since these are the building blocks of hormones.

+ Much of our foods are full of harmful toxins that are upsetting hormones.  Cows are not supposed to produce milk all year round – they are injected with hormones to aid in continual lactation.  These hormones of course make their way into the milk.  You don’t need to be Einstein’s little brother to work that one out.  Same goes for many meats – specifically chicken.  There is a link between chicken and hormone imbalance.  You might like to read more about that here.

+ In the instance of endometriosis or other unkind uterine growth we must consider contributing factors.  Diet in these instances also plays a huge role. Avoiding inflammatory foods which can ‘feed’ the root problem can be essential to help manage and heal endometriosis and alike.  Foods that are typically inflammatory are sugars, dairy, processed foods and in some instances high consumption of meat. Be aware that meat is a key player in paving the way for healthy hormones.  My advice here is to continue to include it in the diet, perhaps once a week/fortnight and see how your body responds.

+ Minimising stress is a key player in all instances.  Find your ‘destressor’ be it meditation or other forms of exercise, downtime on the couch, dancing, laughing – really any or all of the above.  It’s always important to come back to being still enough to allow your body to speak to you about what it needs.


Image courtesy of Pinterest


  • April 7, 2014 By Mandy 7:44 pm

    This is all too familiar to me, great info Nat. I’m aware I have adenomyosis, also have pre period spotting most cycles. PCOS as well. What about lighter, shorter cycles. What does that mean.? Also I have significant ovulation pain most cycles, often last consecutive days, would this all be from adenomyosis? Would love to know your thoughts

  • April 9, 2014 By Kate 10:03 am

    Hi Nat,

    You’re articles are really interesting and I love that they provide me with loads of new information. However, you’re point in this one about animals being injected with hormones bothers me – that’s not the case for dairy cows or chicken meat in Australia at all. Cows produce milk for around 9 months of the year, and have a 3 month ‘drying off’ period, following the birth of their calf. Farmers try to ensure their cows fall pregnant (usually in the good old fashioned way, with a bull) each year so that they have a productive herd – milk production in Australia has nothing to do with injecting hormones. Same for chicken meat – sometimes antibiotics are used to prevent diseases where chickens are housed in sheds, but hormones haven’t been used in the Australian chicken meat industry since the 1960s. Making alarmist and false claims about agriculture like you have here kind of detracts from the legitimacy of your entire article, regardless of the accuracy of your other information.

    • April 9, 2014 By mnfadmin 4:06 pm

      Thanks Kate for your insight. I also read and was made aware on the weekend that thousands of calves are killed every year as a result too – is this true? Perhaps you can help us understand this better.

      I know not everything is as it seems but realistically cows are kept lactating not to feed calves but to be milked for human consumption. Also a pregnant cow shouldn’t be lactating so logic tells me that keeping a cow producing milk rather than constantly pregnant and then feeding is more productive dollar wise?

      Chicken I know is a huge concern – compared how an organic chicken looks compared to a conventional. I’ve spoken about chickens many times on the blog. That much I’m certain on.

  • April 11, 2014 By Jodie ~ Chin up, Lovely 9:48 am

    Like a freaking light bulb just went off! I asked my Dr about this as a teenager and was told – “Oh thats really common and its nothing to worry about”.

    And never questioned it. Cant believe I accepted it for such a long time.

    Thanks Nat!

  • April 16, 2014 By Megan 7:45 am

    I have experienced this twice in the new year so far, thank-you for the informational post!! I will say this, since I’ve gotten back into yoga, lessened my meat and soy consumption, and have chosen veggies to be a weekly source of iron and protein, my cycle and PMD symptoms have gotten better. My cramps aren’t as painful and my cycle is shorter. Hopefully some of these tips may be beneficial for someone.

  • April 17, 2014 By Shay 9:55 pm

    Hi Nat. Quick question. If you have a few days of light spotting before your period, is day one of your cycle considered to be the first day of this spotting? Or the first ‘proper’ day of your period?

    • October 6, 2017 By Nat Kringoudis 8:28 am

      From the first day of flow you could that as CD 1. 🙂

  • April 20, 2014 By Fiona 1:59 pm

    great article, we all need a little self care, i love your food suggestions. Have you got a favourite congee recipe?

  • May 2, 2014 By Larissa 6:03 pm

    Hi Nat, I have fibroids and tend to have spotting about 4 days after my period ends for a good week. Is this the same thing?

    • October 6, 2017 By Nat Kringoudis 8:28 am

      No not really (sorry I never saw this comment!) I would be blaming the fibroids for interrupting the flow. Have you tried to treat them?

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