Pain and spotting between periods: what should you know?

Spotting can happen when hormonal changes affect the uterine lining, after a contraceptive change, or from irritation around the cervix. Chlamydia may cause bleeding with pelvic pain, discharge, or urinary symptoms. Endometrial Polyps and Uterine Fibroids can also present with bleeding, while Cervical Dysplasia, cervical cancer, or womb cancer require evaluation when bleeding is unexplained.

Pain may be cramp-like, one-sided, or felt in the pelvis. The combination does not identify one diagnosis, and the amount of spotting does not reliably indicate the cause.

Keep a record of cycle dates, bleeding colour and amount, pain location, sexual activity, contraception, medicines, discharge, fever, and urinary symptoms. Arrange an appointment if the pattern is new, repeats, follows sex, or continues. A clinician may discuss pregnancy testing, infection swabs, cervical screening, examination, or imaging.

Get urgent help for severe or worsening pain, heavy bleeding, faintness, shoulder-tip pain, fever, vomiting, or a possible pregnancy. Prompt review is also needed for bleeding after menopause or symptoms with weakness, unusual discharge, or pain during urination.

Could my contraception, an infection, or a uterine or cervical condition explain this? Which tests are appropriate? How should I monitor the bleeding, and which changes require urgent care?