What should you know about cancer spotting between periods?

The bleeding pattern alone cannot identify the cause. New, unexplained, repeated, or persistent spotting should be assessed, especially when it occurs after sex or after menopause.

Non-cancerous explanations include hormonal contraception, changes around ovulation or perimenopause, cervical irritation, infection, endometrial polyps, and uterine fibroids. Cervical dysplasia may cause no symptoms, although abnormal cervical tissue can sometimes bleed, particularly after contact.

Cervical cancer can present with bleeding between periods, after sex, or after menopause. Womb cancer can also present with abnormal uterine bleeding. These presentations are reasons to investigate the source; they do not show by themselves that cancer is present.

Arrange a clinical appointment rather than waiting through repeated episodes. Record when bleeding begins, its colour and amount, whether it follows sex, associated discharge or pain, your last normal period, contraception, medicines, and any possibility of pregnancy.

Assessment may involve a pregnancy test, pelvic and cervical examination, infection testing, review of cervical screening history, blood tests, ultrasound, or examination of the womb lining. The choice depends on age, menstrual status, symptoms, and examination findings. Screening is designed for people without symptoms, so being up to date does not replace evaluation of new bleeding.

Seek urgent care if bleeding is heavy and accompanied by fainting, severe dizziness, breathlessness, chest pain, or weakness. Possible pregnancy with one-sided pelvic pain, shoulder-tip pain, collapse, or bleeding also requires urgent assessment because an ectopic pregnancy must be excluded.

Contact a clinician promptly for any bleeding after menopause, persistent bleeding after sex, worsening pelvic pain, offensive discharge, or spotting that keeps returning. Urgency comes from the bleeding pattern and accompanying symptoms, not from an assumption about how likely cancer is.

Clarify which part of the reproductive tract seems to be bleeding, whether cervical examination or infection testing is needed, and whether imaging or sampling of the womb lining is appropriate. Confirm how and when results will arrive, what change should trigger faster care, and whether any medicine or contraceptive could be contributing.