What should you know about early period spotting?

Spotting can happen when hormone levels shift, after starting or missing hormonal contraception, around ovulation, or when the cervix is irritated. Pregnancy-related bleeding is another possibility if pregnancy could occur. Bleeding between periods may also be associated with conditions such as cervical dysplasia, endometrial polyps, or uterine fibroids. Less commonly, it can be linked with cervical cancer or womb cancer. Chlamydia and other infections may cause bleeding with pelvic pain, unusual discharge, or pain during sex. The pattern and accompanying symptoms help guide assessment.

Record the first day, colour, amount, duration, cycle timing, pain, discharge, medicines, and contraception. Take a pregnancy test if pregnancy is possible. Arrange a routine appointment when spotting is new, recurrent, occurs after sex, or continues without a clear explanation. A clinician may examine the vagina and cervix, test for infection, and discuss cervical screening or imaging according to your age, history, and findings.

Get urgent medical help if bleeding is heavy, you feel faint or weak, or you have severe pelvic pain, one-sided pain, fever, or feel acutely unwell. Seek prompt assessment for bleeding during pregnancy or after menopause. These patterns need evaluation even when the bleeding is small.

Ask whether pregnancy or infection testing is appropriate, whether your cervical screening is up to date, and what examination or scan might explain the pattern. Tell the clinician about contraception, recent procedures, and any bleeding after sex.