Backache with bleeding between periods: what to do

Bleeding between expected periods is sometimes called intermenstrual bleeding or spotting. Hormonal changes, contraception and changes around ovulation can be relevant, while infection, endometrial polyps or uterine fibroids may also present with unexpected bleeding and pelvic or back discomfort. Chlamydia can present with bleeding between periods, often with few other symptoms. Cervical dysplasia, cervical cancer and womb cancer may include abnormal bleeding among their presentations, but this symptom pattern does not establish any diagnosis.

Record when bleeding begins, whether it is spotting or a heavier flow, its colour, and any clots. Add the location and intensity of the backache, your usual period dates, recent sex, contraception changes, discharge, fever, urinary symptoms and pregnancy possibility. Use a pad if that makes the amount easier to monitor. Book an appointment even if the bleeding stops when it is new, recurrent, follows sex or occurs after menopause. Testing may include a pregnancy test, infection testing, examination or imaging according to your history.

Get urgent medical help for heavy bleeding, severe or one-sided pelvic pain, fainting, pronounced dizziness, shoulder-tip pain, breathlessness, fever, repeated vomiting or possible pregnancy with pain or bleeding. These signs can accompany significant blood loss, infection or a pregnancy-related emergency. New weakness in the legs, loss of bladder or bowel control, or numbness around the groin also requires emergency assessment because it may arise from serious pressure on spinal nerves.

Explain whether the bleeding happens after sex, whether cycles have changed and whether the pain feels muscular or deep in the pelvis. Ask which causes fit your pattern, whether cervical screening is due, whether infection or pregnancy testing is appropriate, and how to manage discomfort safely while awaiting results. Bring a list of medicines and hormonal contraception, including anything recently started or stopped.