What should you know about heavy period between periods?

Bleeding between expected periods may be spotting, a flow similar to a period, or bleeding after sex. The timing and amount can help a clinician understand the pattern, but they do not establish a diagnosis by themselves. Possible explanations include hormonal changes, polycystic ovary syndrome, perimenopause, uterine fibroids, endometrial polyps, adenomyosis, or a thickened uterine lining such as endometrial hyperplasia. Pregnancy-related bleeding also needs consideration when pregnancy is possible.

Record the first and last day of each episode, how quickly products become soaked, clots, pain, discharge, bleeding after sex, and any missed period. Mention contraception, medicines that affect clotting, recent procedures, and whether you could be pregnant. Heavy bleeding can contribute to iron deficiency anaemia, which may cause tiredness, breathlessness, headaches, or reduced exercise tolerance.

Arrange a medical appointment rather than waiting through repeated episodes. A clinician may check for pregnancy, review your medicines and contraception, examine you, and request blood tests or pelvic imaging. Keep a simple bleeding diary and bring a list of medicines, supplements, and recent changes. Use external protection if you are unsure how much you are bleeding, and avoid inserting anything vaginally if you have been advised to do so after a procedure.

Do not assume that bleeding between periods is caused by stress or a contraceptive change without checking. Those factors can matter, but persistent or heavy bleeding needs its own assessment.

Seek urgent help for heavy bleeding with fainting, severe dizziness, unusual weakness, shortness of breath, chest discomfort, severe abdominal or pelvic pain, or a possible pregnancy. Get prompt medical advice for fever, bad-smelling discharge, or bleeding after menopause. The urgency comes from the amount of bleeding, associated symptoms, and pregnancy context—not from assuming that the bleeding represents a particular condition.

Could my bleeding be related to contraception, fibroids, polyps, hormonal changes, or pregnancy? Do I need a pregnancy test, blood count, iron test, or scan? What should I record before follow-up? Which symptoms mean I should seek urgent help?