Bright red bleeding between periods: what to know

The colour alone cannot identify the cause. Flow, timing, pregnancy possibility, pain, discharge, medicines and recent sex or pelvic procedures give a clinician more useful clues.

Fresh-looking blood may come from the vagina, cervix or uterus. Hormonal cycle changes, contraception, irritation after sex, infection, cervical changes, endometrial polyps and uterine fibroids can all be considered. Cervical cancer and womb cancer can present with unexpected vaginal bleeding, but colour does not distinguish cancer from other causes.

Bleeding that seems vaginal can occasionally come from the urine or rectum. Notice where the blood appears, whether it mixes with discharge, and whether it occurs after sex.

Record the start time, amount, clots, cycle day and associated symptoms. Use a pad if that makes the flow easier to monitor. Arrange a medical appointment for repeated bleeding, bleeding after sex, unusual discharge, pelvic discomfort or a new pattern.

Take a pregnancy test if pregnancy is possible. At the appointment, mention contraception, medicines that affect bleeding, cervical screening history and any chance of a sexually transmitted infection. Testing may include a pregnancy test, infection swabs, an examination, blood tests or pelvic imaging, depending on your history.

Get urgent medical help if bleeding is heavy or rapidly increasing, or if you feel faint, very weak, short of breath or confused. Sudden severe pelvic or abdominal pain also needs urgent assessment.

If pregnancy is possible, seek urgent care for bleeding with one-sided pain, shoulder-tip pain, dizziness or fainting. Fever, severe pain or foul-smelling discharge also warrants prompt attention.

Ask which source of bleeding seems most likely, whether pregnancy or infection testing is appropriate, and whether your cervix needs examination. You can also ask how to monitor the next cycle and what change should bring you back sooner.