What should you know about painless bleeding between periods?

Bleeding between periods includes spotting or bleeding outside your expected menstrual flow. Hormonal contraception, changes in ovulation, irritation after sex and infections such as chlamydia can contribute. Growths such as endometrial polyps, uterine fibroids or cervical dysplasia are other possible explanations. Less commonly, bleeding can be a presentation of cervical cancer or womb cancer; bleeding alone cannot identify its cause.

A healthcare professional may ask about your cycle pattern, contraception, pregnancy possibility, sexual health and any medicines. They may examine the vagina and cervix and arrange pregnancy testing, infection testing or imaging according to your circumstances.

Record when the bleeding starts, how long it lasts, whether it follows sex, and whether it is light spotting or a flow. Book an appointment if the pattern is new, keeps returning, happens after sex or occurs after menopause. Do not stop prescribed contraception without advice. A clinician can explain whether testing for infection, cervical changes, polyps or fibroids is needed.

Seek urgent care if bleeding is heavy, you feel faint, have severe pelvic pain, shoulder-tip pain, fever or a positive pregnancy test with bleeding. These combinations can signal a problem that needs rapid assessment. Bleeding after menopause also warrants prompt review, even when it is painless or limited to spotting.

Ask what causes fit your history, whether pregnancy or infection testing is needed, whether your cervical screening is up to date, and which changes require urgent help. Ask when to return if the bleeding settles but later comes back.