What should you know about very dark spotting between periods?

Blood that leaves the uterus slowly can oxidise and appear brown or nearly black. The colour does not identify the cause by itself. Hormonal contraception, changes around ovulation, irritation after sex, pregnancy-related bleeding, or an infection such as Chlamydia can cause spotting. Polyps and fibroids can also contribute to bleeding between periods.

Less common but important causes include Cervical Dysplasia, Cervical Cancer, or Womb Cancer. This does not mean dark spotting indicates cancer; most episodes have other explanations. The pattern matters: note timing, amount, odour, pelvic pain, bleeding after sex, and whether periods have changed. Bleeding after menopause needs medical review even if it is light.

Track each episode and arrange a clinical review if spotting is new, keeps recurring, follows sex, or occurs with discharge or pelvic pain. Tell the clinician about contraception, medicines, pregnancy possibility, and your last cervical screening. Avoid douching. If an infection is possible, avoid sex or use protection until assessed and treated, and partners may need advice.

Seek urgent care for heavy bleeding, severe or one-sided pelvic pain, faintness, marked weakness, fever, or bleeding during a possible pregnancy. Prompt review is also needed for bleeding after menopause, repeated bleeding after sex, or spotting with foul-smelling discharge. Do not wait for a routine appointment if symptoms are rapidly worsening.

Ask what examinations or tests may explain the spotting, whether you need infection testing or cervical assessment, and which symptoms should prompt urgent help. Ask how to manage contraception while the cause is being checked.