Early spotting before your period

Spotting means light bleeding outside your usual menstrual flow. It can occur around ovulation, after a change in hormonal contraception, or when the cervix is irritated after sex. Pregnancy-related bleeding is another possibility if conception could have occurred. Infection such as chlamydia may cause bleeding with pelvic discomfort, unusual discharge, or pain during sex. Less common causes include cervical dysplasia, cervical cancer, womb cancer, endometrial polyps, or uterine fibroids. A single episode does not identify the cause, and the presence of spotting does not by itself mean cancer.

Record when the spotting starts, its colour, amount, duration, relationship to sex or your cycle, and any pain or discharge. Take a pregnancy test if pregnancy is possible. Avoid douching, and use a pad if you need to monitor bleeding. Arrange a clinician review if spotting recurs, follows sex repeatedly, occurs after menopause, or comes with discharge, pelvic pain, or changes in your usual cycle. Assessment may include a pregnancy test, infection testing, an examination, and cervical screening when appropriate.

Seek urgent help for heavy bleeding, severe or one-sided pelvic pain, fainting, marked dizziness, fever, or bleeding during a possible pregnancy. Contact a clinician promptly for bleeding after menopause, repeated bleeding after sex, or spotting with persistent pain or unusual discharge. These patterns need assessment because a symptom can have several causes, including conditions that benefit from early treatment.

Ask: Could this be related to contraception or pregnancy? Do I need an infection test or examination? When is cervical screening due? Could a polyp or fibroid explain the pattern? Which changes should prompt urgent review?