Unexplained spotting between periods: what to know

Unexplained spotting between periods should be documented and assessed if it persists, returns or comes with pain or other symptoms. A small amount of blood does not identify the cause by itself, and many explanations are treatable.

Spotting may follow ovulation, a change in hormonal contraception, a missed dose, or irritation after sex. Chlamydia and other cervical infections can cause inflammation and bleeding. Cervical dysplasia, cervical cancer, endometrial polyps and uterine fibroids can also present with abnormal bleeding. Womb cancer is another possible presentation, although spotting does not mean that cancer is the cause.

The pattern matters: bleeding after sex, discharge, pelvic pain, a late period or a new medicine can guide the assessment. A clinician may consider pregnancy testing, an examination, cervical screening history, infection tests or ultrasound.

Write down the day spotting starts and stops, its colour, whether it follows sex, and any pain or discharge. Note contraception, missed tablets, medicines and the date of your last normal period. Arrange a routine appointment if the cause is not obvious or the spotting returns. If pregnancy is possible, take a test and share the result. Avoid self-treating with leftover antibiotics.

Get urgent help if spotting becomes heavy, you feel faint, or you develop severe pelvic pain, shoulder-tip pain, fever or unusual weakness. If you may be pregnant, pain or bleeding needs prompt assessment because pregnancy-related complications can require urgent care. Recurrent light spotting still deserves a planned review.

Ask what causes fit your timing and symptoms, whether you need pregnancy or infection testing, and whether your cervical screening is up to date. Ask what an ultrasound could show, when to return if spotting continues, and which change should trigger urgent care.