What should you know about unusual bleeding between periods?

Intermenstrual bleeding may reflect ovulation, a change in hormonal contraception, missed contraception, or irritation. Chlamydia and other cervical infections can inflame tissue and cause spotting. Endometrial polyps and uterine fibroids can cause bleeding from the lining of the womb or affect how it contracts.

Cervical dysplasia and cervical cancer can present with bleeding between periods. Womb cancer can also present with abnormal bleeding, particularly after menopause. Bleeding itself does not identify its cause, and most people need an individual assessment rather than a conclusion based on one episode.

Keep a simple record of the date, flow, colour, clots, pain, medicines, contraception, and any discharge. Take a pregnancy test if pregnancy is possible, and arrange a clinician review if the bleeding is unexplained or returns. Assessment may include an examination, pregnancy or infection testing, blood tests, cervical screening, or imaging.

Use pads if you need to track flow. Continue prescribed contraception unless a clinician tells you otherwise, but mention any recent change or missed dose. Avoid vaginal products that sting or worsen irritation.

Get urgent care for bleeding that is heavy or does not settle, severe abdominal or pelvic pain, faintness, breathlessness, fever, or bleeding with a possible pregnancy. After menopause, report any vaginal bleeding promptly even if it is light.

Ask which causes fit your age, cycle pattern, medicines, and pregnancy possibility; whether you need infection testing or imaging; and how results will guide treatment. If surgery is mentioned, ask what problem it is intended to treat and what alternatives exist.