Excessive bleeding between periods: what to know

Bleeding outside a period can follow changes in contraception, ovulation or hormone levels. Chlamydia and other infections may cause bleeding with discharge or pelvic discomfort. Endometrial polyps and uterine fibroids can also cause irregular bleeding. Cervical dysplasia and cervical cancer may present with abnormal bleeding, while womb cancer is another possibility that requires medical investigation. The symptom does not tell you which condition is present; most causes need history and examination to distinguish them.

A clinician may ask about pregnancy possibility, medicines, contraception, cycle pattern and associated pain. Tests can include a pregnancy test, infection testing, blood tests, cervical assessment or an ultrasound, depending on your circumstances.

Book an appointment if the bleeding repeats, follows sex, occurs after menopause, or is accompanied by pain or discharge. Keep a record of dates, flow, clots, triggers and other symptoms. If pregnancy is possible, mention it promptly. Treatment depends on the cause and may involve changing contraception, treating infection, or managing a polyp, fibroid or cervical finding. A radical hysterectomy is used only for selected cancers and is not a routine response to bleeding.

Get urgent care for very heavy bleeding, faintness, marked weakness, severe pelvic pain, fever, or bleeding during pregnancy. Seek prompt review for bleeding after menopause or bleeding with unexplained weight loss. Do not wait for a routine appointment if you feel unwell or symptoms are rapidly worsening.

What could explain my bleeding pattern? Do I need a pregnancy or infection test? Is my cervix or womb likely to need imaging? Which treatments fit the cause, and what symptoms should trigger urgent care?