Cramping and spotting between periods

Light bleeding may occur when hormone levels shift, after starting or missing hormonal contraception, or after sex. Cramping can come from uterine contractions, bowel symptoms, or inflammation in the pelvis. An infection such as Chlamydia can cause bleeding between periods, pelvic pain, pain during sex, or unusual discharge. Fibroids and endometrial polyps may also affect bleeding patterns. A symptom is not a diagnosis: cervical cancer and womb cancer are less common explanations, but unusual bleeding still needs attention, especially after menopause.

Record when the spotting starts, its colour and amount, the location and severity of cramps, your cycle dates, contraception, medicines, pregnancy possibility, discharge, fever, and pain during sex. Arrange a clinician visit if this is new, recurrent, or unexplained. Assessment may include a pregnancy test, pelvic examination, infection testing, and other checks chosen from your history. Do not stop prescribed contraception without advice; use a pad if you need to monitor bleeding.

Seek urgent medical help for severe or one-sided pelvic pain, fainting, marked dizziness, shoulder-tip pain, heavy bleeding, fever, or a positive pregnancy test with pain or bleeding. Prompt assessment is also sensible for bleeding after sex, bleeding after menopause, new bleeding with unusual discharge, or symptoms that keep returning.

Could my contraception, medicines, infection, or pregnancy explain this pattern? Which examination or tests are appropriate? What changes in bleeding or pain should make me seek urgent help?