What should you know about vaginal bleeding between period?

Intermenstrual bleeding may be light spotting or a heavier episode. Hormonal contraception, missed doses, ovulation, pregnancy, or changes around menopause can alter the cycle. Chlamydia and other infections may cause bleeding from the cervix. Cervical dysplasia and cervical cancer can present with abnormal bleeding. Polyps, uterine fibroids, and womb cancer can also cause bleeding from inside the uterus; the pattern alone cannot tell which explanation applies.

A clinician may ask about cycle dates, medicines, contraception, pregnancy possibility, pain, discharge, and bleeding after sex. Depending on your history, assessment may include a pregnancy test, examination, infection testing, or imaging.

Keep a record of each episode, including its timing, amount, duration, colour, pain, and possible trigger. Book a medical review for bleeding that is new, returns, follows sex, occurs after menopause, or changes your usual cycle. Take a list of medicines and contraception to the appointment. Do not douche, and use infection precautions when relevant.

Get urgent help if bleeding is heavy or comes with faintness, severe abdominal or pelvic pain, shoulder-tip pain, or possible pregnancy. Seek prompt assessment for fever, offensive discharge, or increasing weakness. These signs can indicate blood loss, infection, or a pregnancy-related complication and should not wait for a routine review.

Ask what source of bleeding seems most likely from your history, which tests are appropriate, and when to seek help while waiting. Ask whether fibroids, polyps, infection, or cervical changes need checking, and what treatment would depend on the result. A radical hysterectomy is a specialised cancer operation, not a default response to spotting.