Bleeding or blood-stained discharge between periods

The source may be the vagina, cervix, or womb. Timing, pregnancy possibility, contraception, pain, odour, itching, bleeding after sex, and changes in the menstrual cycle help a clinician decide which examination or tests are appropriate.

Hormonal cycle changes and hormonal contraception can cause spotting. Other possibilities include irritation, infection such as chlamydia, cervical changes, endometrial polyps, or uterine fibroids. Pregnancy-related bleeding must also be considered when pregnancy is possible.

Cervical cancer and womb cancer can present with bleeding outside the expected period, but bleeding does not establish either diagnosis. Assessment is particularly important after menopause, after sex, or when the symptom keeps returning. Testing is chosen according to age, history, examination findings, and pregnancy status.

Arrange a primary care or gynaecology appointment. Record the first and last day of recent periods, when the discharge appears, its colour and smell, the amount of blood, and whether it follows sex. Include pelvic pain, pain during sex, urinary symptoms, itching, fever, and any missed period.

Take a home pregnancy test if pregnancy is possible, while recognising that urgent warning signs need care regardless of the result. A clinician may suggest a pregnancy test, infection swabs or urine testing, examination of the cervix, cervical screening when due, blood tests, or ultrasound. Treatment depends on the identified source rather than the colour of the discharge.

Seek urgent medical care if bleeding is rapidly heavy, you feel faint or markedly weak, or you have severe pelvic or abdominal pain. If pregnancy is possible, bleeding with one-sided pain, shoulder-tip pain, dizziness, or fainting needs emergency assessment because internal bleeding is possible.

Contact a clinician promptly for fever, worsening pelvic pain, foul-smelling discharge, or feeling very unwell, as these features may occur with infection. Bleeding after menopause should be assessed even when it is light or happens only once.

Ask where the blood appears to be coming from, whether pregnancy and infection have been excluded, and whether the cervix needs examination. Clarify which test results you will receive, how they will be communicated, what treatment fits the cause, and what symptom changes should trigger urgent reassessment.