Causes of vaginal bleeding between periods

Examples include breakthrough bleeding with hormonal contraception, chlamydia or another infection, cervical surface changes, endometrial polyps, and uterine fibroids. Cervical and womb cancers can also present with unusual bleeding, so persistent or unexplained episodes need assessment; the symptom alone does not identify the cause.

Light spotting near a contraception change has a different context from bleeding after sex, repeated bleeding at unrelated points in the cycle, or bleeding with pelvic pain. Colour alone cannot distinguish a harmless cause from one that needs treatment.

Your clinician will consider cycle timing, pregnancy possibility, contraceptive use, medicines, infection exposure, cervical screening history, and symptoms such as discharge or pain. Depending on that history, checks may include a pregnancy test, infection swabs or urine testing, examination of the vagina and cervix, blood tests, ultrasound, or a closer look inside the cervix or womb.

Arrange a medical or sexual-health appointment for bleeding between periods, especially when it recurs. Record when the bleeding starts, its amount, whether it follows sex, any missed tablets or contraception changes, pain, discharge, and the dates of your usual periods.

Take a pregnancy test if pregnancy is possible. Avoid assuming that contraception is the cause until other relevant possibilities have been considered. Treatment follows the diagnosis: infection may need antimicrobial medicine, while a polyp, fibroid, cervical change, or hormone-related pattern has a different pathway.

Seek urgent assessment if you recently missed a period and have unusual bleeding with abdominal or pelvic pain, because an ectopic pregnancy must be excluded. Immediate help is also appropriate for very heavy bleeding, fainting, severe worsening pain, marked weakness, or difficulty breathing.

Promptly book an appointment for bleeding after sex, repeated spotting, bleeding with unusual discharge, or any new bleeding after menopause. Escalation is based on the bleeding pattern and accompanying symptoms, not on an assumption about which condition is most common.

Ask whether pregnancy and infection have been excluded, whether your cervix needs examination, and whether imaging is appropriate. Clarify what change in bleeding should trigger urgent care and when to return if initial tests are reassuring but spotting continues.