Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Stains (Ketamim)

A bloodstain found on clothing or another object can sometimes make a woman niddah, depending on the circumstances.


Discovering an unexpected bloodstain can be stressful. Besides being suddenly required to separate from her husband, a woman is sometimes faced with the prospect that her normal menses will begin before she can go to the mikveh, prolonging the separation. Furthermore, she often wonders if there is something medically wrong.

According to Torah law, a woman becomes niddah only when a bodily sensation (hargashah) accompanies her uterine bleeding.

Our Sages, however, decreed that a bloodstain found on clothing or another object, unaccompanied by hargashah, can also render a woman niddah. However, they enacted several leniencies as part of this decree, to avoid overburdening women by causing them to become niddah frequently from extraneous stains. These leniencies are listed below.

Laws of Stains


The first four leniencies listed here apply only when there has been no hargashah. Therefore, they do not apply to any discharge found on a bedikah cloth, or another item inserted internally such as a tampon or diaphragm, because the sensation of inserting or removing the item could have masked a hargashah.

1) The size of the stain

Only a stain larger than the size of a gris, roughly the area of a circle about 19 millimeters in diameter (approximately 280 mm2, about the area of a US dime or an Israeli shekel), renders a woman niddah. This measure is one of area, so a long narrow stain may still be smaller than a gris. When a woman is certain that a stain is smaller in area than a gris, she may be confident that it did not make her niddah.

When several smaller stains are found on the body, they render her niddah if the total surface area adds up to more than the size of a gris. When several smaller stains are found on a garment or other surface, the area of each stain is considered separately.

2) The type of surface on which the stain was found

The laws of niddah, and particularly the decree about stains, are closely associated with the laws of ritual impurity (tumah v’taharah). Accordingly, our Sages ruled that a stain would have halachic significance only if it could render the object on which it was found ritually impure. Thus, a stain found on an object that is not susceptible to ritual impurity (e.g., a plastic chair or toilet seat, or on the floor) does not render a woman niddah. There is a dispute among contemporary halachic decisors as to whether synthetic fabrics such as nylon are susceptible to ritual impurity; if a stain is found on a garment made from synthetic fabric, a specific halachic question should be asked.

Our site follows the halachic ruling that disposable pantiliners and pads are not susceptible to ritual impurity, so that a stain found on a disposable pantiliner or pad of any color does not make a woman niddah. If a woman uses a colored pantiliner, there are even more grounds for leniency. Please see our article on feminine hygiene pads for more information.

According to many authorities, a stain on toilet paper, a toilet seat or toilet water is treated as a stain on an object that is not susceptible to ritual impurity. But if blood is found on any of these within seconds of urinating, the leniencies of stains may not apply.  Please see our article Toilet Paper for more information.

3) The color of the surface on which the stain was found

A stain found on a colored surface does not render a woman niddah. Therefore, it is highly recommended that women wear colored underwear (except during the seven clean days) and sleep on colored sheets, in order to avoid becoming niddah through staining.

This leniency applies to items of any color (except off-white and pale beige, which are considered shades of white). A woman can choose colors light enough that she will notice any staining, without the risk of a stain making her niddah.

4) The location of the stain

Only stains found where they could have come directly from vaginal bleeding can render a woman niddah. Thus stains found on the inner surface of the legs, or on the hands or feet, or on clothing from the hips down, pose halachic questions, but those on the upper body, or arms do not – unless a woman has done handstands or other acrobatics.

The following two leniencies apply to external stains, and may also apply to blood found internally (e.g., on a diaphragm) and to questionable bedikah cloths:

5) A stain attributable to other causes

If the stain could reasonably have come from another source, it does not make a woman niddah. For example:

  • If she has a wound on her body, to which the blood can reasonably be attributed (see Dam Makkah).
  • If she was working with blood, e.g., drawing blood in a laboratory, suturing a wound, or cleaning chickens.
  • If she can attribute the blood she found to someone else, e.g., she lifted a child with a nosebleed.

For women who fallow Ashkenazi rulings, the rules for attributing a stain to an external cause are more stringent during the first three of the seven blood-free days. Thus, if she is not absolutely sure that the blood is from an external source, she should consult a halachic authority.

6) The color of the stain

A flow or stain makes a woman niddah only if its color is one of those that halacha stipulates as niddah colors. Reds generally make a woman niddah; yellows or greens usually do not. Pink, brown, gold, orange, black or reddish shades should be evaluated by a halachic authority. Stains are best evaluated in natural sunlight (holding the cloth or stained item in the shade rather than in direct sunlight), as colors may appear different in artificial light.

Precautions for avoiding stains

It is completely legitimate, and halachically recommended, to rely on the leniencies built into the laws of stains. We recommend following the following precautions to avoid becoming niddah unnecessarily:

  • Wearing colored underwear or pantiliners (according to many opinions, including those followed by this website, disposable white pantiliners are also effective)
  • Not looking at toilet paper or taking care to wait fifteen seconds between urinating and wiping
  • Having relations on colored sheets, waiting a few minutes for both spouses to clean themselves afterwards, and using dark colored towels for cleaning. In any instance of finding bleeding immediately after relations, a halachic authority should be consulted as soon as possible
  • Not inserting tampons when not already in niddah
  • Not performing bedikot when there is no halachic requirement to do so

Staining or a Flow?

These leniencies above apply to the staining many women experience at various points during the reproductive life cycle (e.g., postpartum, perimenopause, while taking the active pills of hormonal contraceptives). They are not intended to prevent a woman from becoming niddah when she menstruates. A woman who feels a distinct hargashah or experiences a  flow of blood becomes niddah even if she is wearing black underwear or disposable pantiliners or pads, and doesn’t look at toilet paper.

There is no clearly defined halachic boundary between “staining” and a “flow.” In practice, it is often relatively easy to distinguish. As a rule of thumb, bleeding that is too heavy to be contained by pantiliners, and would require a pad or tampon, is probably a flow. If she actually sees blood leaving her body, she is niddah. In doubtful situations, a specific halachic question should be asked.

Conduct while Staining

If a woman has spotting that does not meet the criteria for ketamim (and thus does not make her niddah), we usually recommend that she avoid actual relations until she has been clear of staining for about 24 hours. Other forms of physical affection continue as usual.

Refraining in this manner is a voluntary precaution against a flow beginning during relations, and also gives her time to evaluate the situation and determine whether the staining will develop into a real flow. It is not a halachic requirement, and does not indicate that she considers herself niddah.

Medical Aspects of Staining

In addition to halachic concerns, staining raises medical concerns. The urgency of the need to consult a physician depends on the type of bleeding and the woman’s medical history. The following are general guidelines. Any woman who is worried about an ongoing situation should not hesitate to seek medical counsel.

Pre-menopausal women who have more than one cycle of bleeding between periods, or periods that last more than one week, or changes from their usual pattern should make an appointment to see their physician when it is convenient.

Women with bleeding in pregnancy should always consult their healthcare provider. If the bleeding is accompanied by pain or is significant enough to require a pad, this evaluation should be in an emergent setting (immediate office appointment, urgent care center, or emergency room). Minor spotting can be discussed with a physician in a clinic during normal work hours within one or two days.

Menopausal woman who experience spotting after at least a year without bleeding should make an appointment to see their physician within a few days.

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All health and health-related information contained within Nishmat's Women's Health & Halacha Web site is intended to be general in nature and should not be used as a substitute for consulting with your health care professional. The advice is intended to offer a basis for individuals to discuss their medical condition with their health care provider but not individual advice. Although every effort is made to ensure that the material within Nishmat's Women's Health & Halacha Web site is accurate and timely, it is provided for the convenience of the Web site user but should not be considered official. Advice for actual medical practice should be obtained from a licensed health care professional.

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