Causes of blood spotting after a period

A small amount may occur when hormone levels shift or after starting, stopping, or missing hormonal contraception. Bleeding that returns, lasts, or follows sex deserves assessment rather than an assumption about its cause.

The apparent end of a period may be followed by a little older blood leaving the uterus. Mid-cycle hormone changes can also cause light spotting. Other possibilities include irritation after sex, chlamydia or another infection, endometrial polyps, and uterine fibroids. Cervical dysplasia, cervical cancer, and womb cancer can present with bleeding between periods, but the symptom alone does not identify the cause.

If pregnancy is possible, unexpected bleeding needs a pregnancy test because early pregnancy problems may begin with spotting, sometimes with pelvic pain.

Record when the bleeding starts, its colour and flow, whether it follows sex, and any pain, discharge, fever, dizziness, or missed period. Note contraception and medicines, including missed doses. Arrange a routine appointment if spotting recurs, continues, or is new after menopause. A clinician may discuss a pregnancy test, infection testing, a pelvic examination, cervical screening history, or imaging according to your circumstances.

Get urgent help for heavy bleeding, fainting, marked dizziness, breathlessness, severe or one-sided pelvic pain, shoulder-tip pain, or bleeding with a positive pregnancy test. Fever, worsening pelvic pain, or unpleasant-smelling discharge also needs prompt assessment. Any vaginal bleeding after menopause should be medically checked, even if it happens only once.

Ask which causes fit the timing of your bleeding, whether you need pregnancy or infection testing, and whether your contraception could be contributing. You can also ask what examination or scan would clarify the cause and which change in bleeding should trigger urgent care.