Lower abdominal pain and bleeding between periods

Spotting or bleeding outside a usual period may arise from hormonal contraception, irritation of the cervix, infection, polyps, fibroids, or changes in the lining of the womb. A pelvic infection such as Chlamydia can cause lower abdominal pain, unusual bleeding, discharge, or pain with sex. A cervical or womb condition may also cause abnormal bleeding. These symptoms do not identify one diagnosis by themselves, and a breast-style assumption that bleeding means cancer would be unsafe; a clinician needs the pattern and examination.

Record when the bleeding began, its amount and colour, where the pain is located, and whether it follows sex, exercise, or a missed period. Arrange a medical assessment if this is new, recurring, or accompanied by discharge, fever, pain during sex, or urinary symptoms. A clinician may ask about contraception and pregnancy possibility, examine the pelvis, and arrange tests based on your history.

Seek urgent care for severe or worsening pain, faintness, marked weakness, shoulder-tip pain, fever with feeling very unwell, or heavy bleeding. If pregnancy is possible, pain with bleeding needs prompt assessment because an ectopic pregnancy can become an emergency.

Could the bleeding be related to contraception, infection, a polyp, or a fibroid? Do I need a pregnancy test, infection testing, cervical assessment, or an ultrasound? Which changes should make me seek urgent help?