Dark red spotting between periods

Dark blood is commonly blood that has remained in the vagina or uterus longer before passing out. Spotting between expected periods can occur around ovulation, after starting or changing hormonal contraception, or after sex if the cervix is irritated. It can also occur with pregnancy, so consider whether pregnancy is possible.

Chlamydia can present with bleeding between periods and may also cause discharge, pelvic pain, pain during sex, or burning when urinating. Cervical dysplasia, cervical cancer, endometrial polyps, uterine fibroids, and womb cancer can also present with abnormal bleeding. A symptom cannot determine which condition, if any, is present.

Write down the first and last day of each episode, the amount, the colour, and any relationship to sex, contraception, or missed doses. Record pain, discharge, fever, urinary symptoms, and whether your periods have changed. Book a medical review when spotting is new, repeats, follows sex, or does not settle. A clinician may discuss pregnancy testing, sexually transmitted infection testing, cervical screening, an examination, or an ultrasound based on your age, medical history, and symptoms.

Get urgent help if bleeding becomes heavy, or if you have severe pelvic pain, fainting, significant dizziness, fever, or weakness. If pregnancy is possible, bleeding alongside one-sided pain, shoulder-tip pain, or faintness requires prompt assessment for an ectopic pregnancy. Any bleeding after menopause should be evaluated rather than monitored at home.

Ask whether the timing suggests ovulation, contraception-related bleeding, irritation, infection, or another cause. Ask if you need pregnancy or Chlamydia testing, whether your cervical screening is current, and what examination or scan would be appropriate if the episodes continue. Bring your bleeding notes and a list of medicines or contraception.