Causes of brown spotting between periods

The pattern and accompanying symptoms matter more than colour alone. New, repeated or unexplained bleeding should be assessed, particularly after menopause.

A clinician considers your age, menstrual pattern, pregnancy possibility, contraception and whether bleeding follows sex. Breakthrough bleeding can occur when starting, missing or changing hormonal contraception. Cervical irritation or infection may produce spotting with discharge or pain. Endometrial polyps and uterine fibroids can alter bleeding patterns. Less commonly, abnormal cells of the cervix or womb can present with unexpected bleeding, so persistent symptoms should not be self-diagnosed.

Mark the spotting on a calendar with its amount, colour and duration. Record missed contraceptive doses, recent medication changes, sex, pelvic discomfort, bleeding after sex, urinary symptoms and unusual discharge. Take a pregnancy test if pregnancy is possible. Do not stop prescribed hormonal contraception without advice, because an abrupt change may make bleeding less predictable.

Book a medical appointment if spotting recurs, persists, begins after menopause, follows sex repeatedly, or occurs with pelvic pain, pain during sex, fever or unusual discharge. Seek urgent care for very heavy bleeding, fainting, severe abdominal pain, or pregnancy with one-sided pain or shoulder-tip pain. Urgency comes from these warning signs, not from how common any particular cause may be.

Ask whether you need a pregnancy test, cervical screening review, infection swabs, pelvic examination, blood tests or ultrasound. Mention the date of your last cervical screening and all medicines or contraceptives. Ask what pattern would warrant follow-up even if an initial examination is reassuring.