Hormonal bleeding between periods: what to know

Bleeding between periods can occur when ovulation changes, hormone levels fluctuate, or the womb lining responds to a new or altered hormonal contraceptive. Missed pills, starting contraception, changing methods, and emergency contraception can also alter the pattern. Hormonal bleeding is often light spotting, but appearance alone cannot confirm the cause.

Other explanations include pregnancy, chlamydia, cervical dysplasia, cervical cancer, uterine fibroids, endometrial polyps, or womb cancer. The symptom does not mean one of these conditions is present; a clinician considers the pattern, age, pregnancy possibility, medicines, examination findings, and other symptoms.

Track the dates, amount, colour, relation to sex, pain, discharge, and contraceptive use. Take a pregnancy test when pregnancy is possible and arrange a medical review if the bleeding recurs, follows sex, or began after a contraceptive change. Keep taking prescribed contraception as directed unless a clinician advises otherwise. A review may involve an examination, infection testing, or further investigation based on your history.

Get urgent help for heavy bleeding with dizziness or faintness, severe pelvic pain, or bleeding during pregnancy. Seek prompt advice for fever, offensive discharge, or bleeding that becomes more frequent or prolonged. Bleeding after menopause always warrants medical assessment, even if it is light.

Could my contraception or a missed dose explain this pattern? Should I test for pregnancy or infection? Which examination or tests are needed? What should I do if the bleeding returns?