What Should You Know About Long Periods of Spotting?

Spotting is light vaginal bleeding that may appear pink, red, or brown. When it continues for a long time or keeps returning, possible explanations include changes in ovulation, starting or changing hormonal contraception, missed contraception doses, pregnancy-related bleeding, or irritation after sex. Infections such as chlamydia can also cause bleeding between periods, sometimes with pelvic discomfort, unusual discharge, or pain during sex.

Growths in the womb, including endometrial polyps or uterine fibroids, can contribute to irregular bleeding. Changes affecting the cervix or womb are less common but need consideration when bleeding is persistent, occurs after sex, or happens after menopause. A symptom alone cannot identify the cause, and a breast- or pelvic-related symptom should not be treated as a diagnosis.

Arrange an appointment with a GP, gynaecologist, or sexual-health clinician if spotting lasts longer than expected for you, returns over several cycles, or has no clear explanation. Write down when it started, how often it appears, its colour and amount, whether it follows sex, and any pain, discharge, fever, dizziness, or pregnancy possibility. Bring a list of medicines and contraception, including recent changes.

Assessment may include a pregnancy test, discussion of your cycle and contraception, an examination, infection testing, blood tests, or an ultrasound. The choice depends on your age, symptoms, medical history, and examination findings. Do not stop prescribed contraception without advice; contact the prescriber if you think it is contributing.

Seek urgent medical help if bleeding becomes heavy, you feel faint or unusually weak, or you have severe or worsening pelvic pain. Get prompt assessment for bleeding during pregnancy, bleeding after menopause, fever with pelvic pain, or bleeding after sex that is new or repeated. These features do not identify a single cause, but they can signal a need for timely examination.

Ask: What causes fit my bleeding pattern and medical history? Do I need a pregnancy test or infection testing? Could my contraception or another medicine be contributing? Would an examination or ultrasound help? Which symptoms should prompt urgent care, and when should I follow up if the spotting continues?