Unexpected bleeding between periods: what to know

Unexpected bleeding between periods deserves assessment when it is new, recurrent, heavy, painful or different from your usual cycle. Spotting may be minor, but the timing outside your expected period helps a clinician decide what to check.

Hormonal contraception, missed pills, ovulation and changes around the start or end of reproductive years can disturb the cycle. Infection such as Chlamydia may inflame the cervix and cause bleeding, including after sex. Polyps and uterine fibroids can bleed because they alter the surface or structure of the womb. Cervical dysplasia and cervical cancer can present with bleeding; bleeding itself does not mean that either condition is present. Womb cancer is less common in younger people but may also present with abnormal bleeding.

A clinician may ask about pregnancy possibility, contraception, sex, pain, discharge and medicines. They may offer a pregnancy test, sexual-health testing, cervical screening review, examination, blood tests or an ultrasound based on your circumstances.

Keep a simple record of dates, flow, clots, pain, sex, contraception and any missed doses. Arrange a consultation if the pattern repeats or has no clear explanation. Use pads if you need to track the amount, and mention bleeding after sex separately. If pregnancy is possible, test promptly and tell the clinician about the result. Treatment depends on the cause rather than the appearance of the blood.

Seek urgent care for very heavy bleeding, faintness, marked weakness, severe or one-sided pelvic pain, fever, or bleeding during pregnancy. These symptoms can indicate substantial blood loss, infection or a pregnancy complication. If bleeding is mild but keeps returning, arrange timely review rather than waiting indefinitely.

Ask whether pregnancy, contraception, infection, a polyp or fibroid could explain the pattern. Ask whether you need an examination, cervical test, infection swabs or ultrasound, and what result would change treatment. Clarify which symptoms require urgent help.