Abdominal cramping and bleeding between periods

The timing, amount of blood, pregnancy possibility, discharge, fever, and location of the pain help a clinician decide what to check. A single episode of light spotting can have a different explanation from recurrent bleeding or worsening pain.

Bleeding may follow a change in hormonal contraception or come from the cervix, vagina, or lining of the uterus. Infection can cause pelvic discomfort, unusual discharge, pain during sex, or bleeding after sex. Fibroids and endometrial polyps may also present with bleeding between periods, sometimes with pressure or cramps.

Cervical dysplasia, cervical cancer, and womb cancer can present with unusual bleeding, but the symptom alone does not identify the cause. An examination and appropriate tests are needed. If a period is late and pregnancy is possible, pain with bleeding must be assessed promptly because an ectopic pregnancy is a concern.

Contact a gynaecology, primary care, or sexual health service for an appointment. Note when the bleeding started, whether it followed sex, how often you change period products, where the cramps are felt, and any fever, discharge, dizziness, urinary symptoms, or missed period. Take a home pregnancy test if pregnancy is possible, but do not delay urgent assessment while waiting for a result.

Testing may include a pregnancy test, infection testing, an examination of the cervix, blood tests, or pelvic imaging, depending on the history. Treatment follows the cause; surgery is not an automatic next step for bleeding between periods.

Seek urgent medical care if you have missed a period and now have bleeding with abdominal or pelvic pain, even if the pain is not severe. Immediate assessment is also needed for severe or one-sided pain, shoulder-tip pain, fainting, marked dizziness, breathlessness, fever with worsening pelvic pain, or bleeding that rapidly soaks through period products.

Bleeding after menopause should be checked even when it is light or happens only once. Recurrent bleeding between periods also deserves an appointment rather than repeated self-treatment with pain relief.

Ask which source of bleeding seems most likely after examination, whether pregnancy and infection have been excluded, and whether you need cervical screening or an ultrasound. Mention medicines, contraception, recent procedures, and any bleeding after sex.