Dark red bleeding between periods: what to know

Blood can look dark red or brown when it leaves the uterus slowly. Bleeding between periods may also be linked with hormonal contraception, ovulation, infection, irritation after sex, polyps, fibroids, or changes in the cervix or womb lining. Chlamydia can cause bleeding between periods, sometimes with pelvic pain, pain during sex, or unusual discharge.

Bleeding between periods is a presentation of cervical cancer, cervical dysplasia, or womb cancer, but the symptom does not determine the cause. Most explanations require an examination and sometimes pregnancy testing, infection testing, cervical assessment, or imaging.

Record when the bleeding started, its colour and amount, whether it followed sex, and where you are in your cycle. Note pain, discharge, fever, dizziness, contraception, medicines, and pregnancy possibility. Arrange a clinical appointment if the bleeding repeats, follows sex, or continues beyond a brief episode. Avoid vaginal products or sex if they increase pain or bleeding, and do not self-treat a possible infection without testing.

Seek urgent care for heavy bleeding, severe or one-sided pelvic pain, faintness, shoulder-tip pain, fever, or feeling very unwell, particularly if pregnancy is possible. Bleeding with dizziness or collapse needs emergency help. New bleeding after menopause also warrants prompt assessment, even when the amount is small.

Ask whether you need a pregnancy test, infection tests, cervical screening or examination, blood tests, or an ultrasound. Ask what treatment depends on the cause and when to return if the bleeding recurs. If a serious cervical cause is found, ask whether specialist treatment such as radical hysterectomy is relevant to your situation.