What should you know about continual bleeding between periods?

Bleeding between periods includes spotting or flow outside your expected menstrual pattern. Hormonal contraception, missed doses, ovulation changes, thyroid problems, pregnancy-related causes, and irritation can contribute. Infections such as chlamydia can also cause bleeding, sometimes with pelvic pain, discharge, or pain during sex.

Structural causes include uterine fibroids and endometrial polyps. Cervical dysplasia and cervical cancer can present with abnormal bleeding, while womb cancer is another possibility that requires medical evaluation. These conditions are not the only explanations, and bleeding alone cannot identify the cause.

Arrange a gynaecology or primary-care review, especially when bleeding continues, returns repeatedly, or began after a change in contraception. Note dates, amount, colour, clots, pain, discharge, medicines, and pregnancy possibility. The assessment may include a pregnancy test, pelvic examination, infection testing, blood tests, or ultrasound.

Treatment depends on the cause and may involve adjusting contraception, treating an infection, or managing a polyp or fibroid. Do not start hormonal treatment without checking why the bleeding is happening.

Seek urgent care for heavy bleeding with dizziness or fainting, severe pelvic pain, shoulder-tip pain, or a possible pregnancy. Prompt review is also needed for bleeding after menopause, bleeding with fever, or new bleeding after sex.

Ask what causes are most relevant to your age and symptoms, which examination or tests you need, whether infection or pregnancy should be ruled out, and how quickly results will be available. If a serious cervical or womb condition is suspected, ask what referral and treatment options would follow.