Heavy bleeding with clots between periods: what to know

Bleeding between periods may follow changes in ovulation, contraception, pregnancy, or medicines. Uterine fibroids and endometrial polyps can cause heavier or irregular bleeding. Chlamydia and other infections can irritate the cervix and lead to bleeding, sometimes after sex. Cervical dysplasia, cervical cancer, or womb cancer can also present with bleeding between periods; this symptom does not show which condition is responsible. Clots often mean blood has collected before leaving the body, but they do not identify the source.

Arrange an appointment if the bleeding is new, heavy, repeated, or happening after sex. Track cycle dates, flow, clots, pain, discharge, fever, and any medicines or contraception. Tell the clinician if pregnancy is possible, if you have pelvic pressure, or if you have missed screening or follow-up. Assessment may include a pregnancy test, examination, infection testing, blood tests, or imaging depending on your symptoms.

Seek urgent help for rapidly increasing bleeding, repeated pad soaking, severe or one-sided pelvic pain, faintness, marked weakness, fever with feeling very unwell, or bleeding during a possible pregnancy. Emergency symptoms need attention regardless of whether you have previously had fibroids, polyps, or irregular cycles.

Ask which causes fit your pattern, whether you need pregnancy or infection testing, and whether an examination or scan is needed. Ask when cervical screening or a womb-lining assessment is appropriate, and which changes should prompt urgent review.