What should you know about red bleeding between periods?

Bleeding between periods includes spotting or flow outside your expected menstrual timing. Hormonal contraception, changes around ovulation, and missed or irregular cycles can alter the lining of the womb. Infection, including [Chlamydia](/conditions/chlamydia/), can affect the cervix and cause bleeding or discharge.

Structural causes include [Endometrial Polyps](/conditions/endometrial-polyps/) and [Uterine Fibroids](/conditions/uterine-fibroids/). Abnormal cells in the cervix, such as [Cervical Dysplasia](/conditions/cervical-dysplasia/), may also present with unexpected bleeding. [Cervical Cancer](/conditions/cervical-cancer/) and [Womb Cancer](/conditions/endometrial-cancer/) are less common causes, but the symptom warrants assessment when it persists, changes, or occurs after menopause. Bleeding alone cannot establish its cause.

Keep a record of dates, colour, amount, clots, pain, sexual activity, contraception, and medicines. Arrange a clinical review if the bleeding repeats, follows sex, occurs after menopause, or is accompanied by pelvic pain, fever, discharge, or possible pregnancy. Assessment may include a pregnancy test, examination, infection testing, and cervical screening when appropriate.

Do not stop prescribed hormonal contraception without advice. Tell the clinician if you use blood-thinning medicine or have a bleeding disorder, since these details change the assessment. Further imaging or sampling may be suggested when the pattern or examination points to a womb or cervical cause.

Get urgent help for heavy bleeding with dizziness, faintness, breathlessness, severe pain, or marked weakness. Seek prompt advice for bleeding during pregnancy, fever with pelvic pain, or bleeding after menopause. A sudden change from your usual pattern also merits timely review, even if the bleeding is light.

Ask whether your pattern suggests a hormonal, infectious, cervical, or womb-related cause; which examination or tests are suitable; and how to manage symptoms while waiting. If a procedure is proposed, ask what it is intended to clarify and what follow-up will involve.