What should you know about constant breakthrough bleeding?

Breakthrough bleeding means bleeding outside the expected time of a period, often while using hormonal contraception. Light spotting may settle after a method is started or changed, but bleeding that continues, becomes heavier, or returns repeatedly should be assessed rather than self-diagnosed.

Hormonal contraception can alter the womb lining and produce irregular bleeding, especially after starting a method, missing doses, changing products, or using some forms continuously. Pregnancy can also cause unexpected bleeding, so a pregnancy test may be relevant when pregnancy is possible.

An infection affecting the cervix, including Chlamydia, may present with bleeding between periods or after sex, sometimes with discharge, pelvic discomfort, or burning when passing urine. A polyp in the womb lining can also cause irregular bleeding. Endometrial Polyps are one possible structural explanation, but bleeding alone cannot identify its cause.

Bleeding details help clinicians narrow the possibilities: note when it began, how often it occurs, whether it follows sex, the amount, its colour, pain, discharge, and any contraception or medicines you use.

Arrange an appointment with a gynaecology or primary-care clinician if the bleeding is ongoing or unexplained. They may ask about contraception, pregnancy possibility, sexual health, medicines, and the pattern of bleeding. Depending on your symptoms, assessment can include a pregnancy test, examination, infection testing, blood tests, or imaging.

Keep taking prescribed contraception as directed unless a clinician advises a change. Do not double doses to stop bleeding, and do not use leftover antibiotics. If sex may have exposed you to an infection, pause sex or use condoms until you have received advice and testing.

Seek urgent medical help for heavy bleeding, faintness, marked weakness, severe or one-sided pelvic pain, shoulder-tip pain, fever, or bleeding during a possible pregnancy. These symptoms need prompt assessment because blood loss, infection, or a pregnancy-related problem may require urgent treatment.

Contact a clinician soon if bleeding follows sex, occurs with unusual discharge or pelvic pain, or continues despite following your contraception instructions. Bring a list of medicines and, if possible, a record of bleeding days and pad or tampon changes.

Ask: Could my contraception or another medicine be contributing? Do I need a pregnancy test or infection testing? What examination or imaging is appropriate? How should I manage the bleeding while we investigate it? Which symptoms should prompt urgent care?