Small bleeding between periods: what to know

Spotting may follow ovulation, a change in contraception, or missed hormonal doses. Chlamydia and other infections can inflame the cervix. Cervical dysplasia and cervical cancer can present with bleeding between periods; the symptom alone does not show that cancer is present. Endometrial polyps and uterine fibroids can cause irregular bleeding by affecting the lining or the shape of the uterus. After menopause, any vaginal bleeding needs assessment because the causes and evaluation differ.

Record the date, amount, colour, and relationship to your cycle, sex, contraception, or medicines. Take a pregnancy test if pregnancy is possible. Arrange a routine appointment for bleeding that recurs, follows menopause, or is accompanied by pain, discharge, dizziness, or tiredness. A clinician may examine the vagina and cervix, test for infection, and consider imaging or sampling of the uterine lining. Treatment depends on the cause rather than the appearance of the blood.

Seek urgent care if bleeding becomes heavy, you feel faint, or you have severe abdominal or pelvic pain, fever, or a positive pregnancy test with pain. Seek prompt assessment for bleeding after menopause or bleeding with a new sexual partner and pelvic discomfort.

Could my contraception or an infection explain this pattern? Do I need cervical or uterine testing? What changes in the bleeding should make me seek urgent help?