Spotting after your period

Spotting is light bleeding outside the expected menstrual flow. It may happen around ovulation, after starting or missing hormonal contraception, or when the cervix is irritated after sex. Pregnancy-related bleeding is another possibility if pregnancy could occur. The pattern, colour, timing and associated pain help a clinician narrow the cause.

Infections such as Chlamydia can cause bleeding after sex or between periods. Benign growths such as endometrial polyps or uterine fibroids may also contribute. Cervical dysplasia and cervical cancer, or changes in the womb lining such as womb cancer, are less common possibilities that should be considered when bleeding is persistent, unusual or accompanied by other warning signs.

Record when the spotting starts, how long it lasts, whether it follows sex, and any pain, discharge or odour. Take a pregnancy test if pregnancy is possible. Arrange a medical appointment if the bleeding recurs, follows sex, occurs after menopause, or is a new change for you. Assessment may include a pregnancy test, examination, infection testing or imaging.

Avoid vaginal douching and do not self-treat with leftover antibiotics. Use pads if you need to monitor the amount, and mention any contraception, medicines or recent procedures at the appointment.

Get urgent help for heavy bleeding, severe or one-sided pelvic pain, fainting, dizziness, fever, or bleeding with a positive pregnancy test. Seek prompt review for bleeding after menopause, bleeding after sex that keeps happening, or spotting with foul-smelling discharge. These patterns need assessment for pregnancy complications, infection or problems affecting the cervix or womb.

Ask what examinations and tests you need, whether pregnancy or infection should be ruled out, and whether cervical screening is up to date. Discuss contraception, medicines, recent procedures and whether ultrasound or referral is appropriate. Ask which changes should prompt urgent care.