Blood spotting after a missed period

A small amount of pink, red, or brown blood may be the delayed start of a period. Ovulation changes, stress, illness, weight change, hormonal contraception, polycystic ovary syndrome, and perimenopause can also alter timing and flow. Brown discharge is often older blood leaving the uterus.

Pregnancy is another possibility when a period is late. Light bleeding can happen in pregnancy, but bleeding alone cannot show whether a pregnancy is developing normally or where it is located. A clinician may use your history, an examination, blood tests, or ultrasound when assessment is needed.

Take a home pregnancy test if pregnancy is possible, following the kit instructions. If it is negative but the period remains absent, repeat it after a few days or arrange a clinical test. Note the bleeding colour and amount, whether it is increasing, and any pain, dizziness, fever, unusual discharge, contraception changes, or missed tablets.

Arrange a routine appointment if spotting recurs, persists, follows sex, or your cycles have changed without a clear reason. Mention medicines and contraception because these can affect bleeding. Do not stop prescribed medicine without advice.

Get urgent medical help if pregnancy is possible and bleeding occurs with strong or one-sided lower abdominal pain, shoulder-tip pain, fainting, marked dizziness, or weakness. These symptoms need prompt assessment for an ectopic pregnancy or significant blood loss.

Seek urgent care for bleeding that rapidly soaks pads, severe pelvic pain, collapse, fever, or feeling very unwell. Contact a clinician promptly for a positive pregnancy test with any bleeding, even when the spotting is light.

Ask whether pregnancy testing should be repeated, whether your contraception or medicines could explain the pattern, and whether you need an examination, infection testing, blood tests, or ultrasound. Describe your usual cycle and the date of your last normal period.