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Bleeding between periods
Category: Women's Health · All women's health symptoms
What it can feel like
Bleeding between periods means any vaginal bleeding outside your normal period — spotting after sex aside (which has its own page), mid-cycle spots, or bleeding at unpredictable times. Contraception is a frequent explanation, but new persistent intermenstrual bleeding deserves a pelvic review.
Possible causes
A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.
Common causes
Bleeding between periods can be associated with hormonal contraception (especially in the first months or with missed pills), ovulation spotting, cervix inflammation or infection including chlamydia, and cervical or uterine polyps.
Other possible causes
Persistent intermenstrual bleeding can also be associated with fibroids, womb lining abnormalities including precancerous change and cancer, and thyroid or clotting problems — the probability of a serious cause rises with age, which is why persistence after 40 is investigated.
Red flags — when to seek help promptly
- Bleeding between periods that persists for more than a few cycles
- Bleeding between periods over the age of 45, or any postmenopausal bleeding
- Bleeding with pelvic pain, fever or an offensive discharge (possible infection)
- Bleeding so heavy it causes dizziness or anaemia symptoms
What a clinician may do
A clinician will take the contraceptive and cycle history, examine the pelvis and cervix, arrange infection swabs and a pregnancy test, and usually a pelvic ultrasound. Persistent cases lead to a camera look inside the womb (hysteroscopy) with a lining sample.
Related guides on MedicalVideos.com
Frequently asked questions
My pill causes spotting — is that always fine?
Breakthrough spotting is common when starting or changing hormonal contraception and usually settles within three months. Spotting that persists beyond that, starts after months of stability, or follows missed pills needs review — infection, polyps and cervix problems also cause it.
Why does age change the urgency?
Womb lining cancer is uncommon in younger women and commoner after 45, while contraceptive and infectious causes dominate earlier. The same symptom therefore triggers different speed of investigation at different ages — persistence at any age earns examination.
Related symptoms — Women's Health
Browse the B section of the A–Z list or return to the Symptoms A–Z hub.