Symptom guide
Spotting between periods: causes, red flags and when to get it checked
Light spotting between periods is common, especially in the first months of hormonal contraception, around ovulation or during perimenopause. Persistent or recurrent bleeding between periods, or bleeding after sex, should be assessed, because infection, polyps, fibroids, and occasionally cervical or womb changes can be responsible.
Last checked: 2026-10-03
Key facts
At a glance.
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Common
Contraception, ovulation and hormonal fluctuations are the most frequent reasons.
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Pregnancy
Spotting can be an early pregnancy sign or a sign of miscarriage or ectopic pregnancy; test if pregnancy is possible.
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Infection
Chlamydia and other infections can cause spotting, often with discharge or pain.
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Persistent
Bleeding between periods that recurs for more than three months, or with bleeding after sex, needs examination.
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Who to see
GP or sexual health clinic; gynaecology for ultrasound or hysteroscopy.
What this symptom usually means
The womb lining is held in place by hormones. When hormone levels fluctuate or are altered by contraception, small amounts of lining can shed and cause spotting. Local problems such as polyps, a cervical ectropion or infection can also bleed. A pregnancy test and a sexual health check are practical first steps.
Possible causes, from most to least common
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Hormonal contraception: breakthrough bleeding with the pill, implant, injection or hormonal coil, especially in the first three to six months or after missed pills.
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Ovulation spotting: light mid-cycle bleeding with a clear stretchy discharge.
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Perimenopause: irregular cycles and spotting due to fluctuating hormones.
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Infection: chlamydia, gonorrhoea, pelvic inflammatory disease and cervicitis.
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Early pregnancy, miscarriage or ectopic pregnancy.
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Cervical ectropion, cervical or endometrial polyps, and fibroids.
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Thyroid disease, polycystic ovary syndrome, stress, weight change and strenuous exercise.
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Endometrial hyperplasia, cervical cancer and uterine cancer, which are less common but important.
Features that point to something more serious
Bleeding that persists or recurs, bleeding after sex, pelvic pain, abnormal discharge, a pelvic mass, heavy bleeding, bleeding after menopause, being overdue for cervical screening, age over 45, and risk factors such as obesity, diabetes or tamoxifen use warrant prompt assessment.
Red flags: when to seek help
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Call 999 or go to A&E: bleeding with severe one-sided pain, dizziness or fainting, or a positive pregnancy test with pain.
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Same-day GP or sexual health clinic: bleeding with fever, severe pelvic pain or foul discharge.
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Urgent GP: bleeding between periods persistent for more than three months, bleeding after sex, or any bleeding after menopause.
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Routine: occasional spotting in the first months of new contraception.
What a doctor will ask and examine
The doctor asks when it happens in the cycle, how much, contraceptive use and missed pills, sexual history, pregnancy chance, pain, discharge, smear history, family history and medicines. They perform an abdominal and, if appropriate, speculum examination, and take swabs.
Tests that are commonly used and why
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Pregnancy test.
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Vaginal and cervical swabs: for chlamydia, gonorrhoea and other infections.
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Cervical screening if due.
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Blood tests: full blood count, thyroid function, and hormone tests where indicated.
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Pelvic ultrasound and hysteroscopy: for persistent bleeding, polyps and thickened lining.
Self-care and the usual route
Keep a diary of bleeding dates and any link to contraception or sex. Take pills consistently and avoid missing doses. Do not stop contraception without advice. Attend cervical screening and sexual health checks, and complete treatment for any infection.
The NHS route is a GP or sexual health clinic, with gynaecology if persistent. Private gynaecology and sexual health clinics offer direct access to swabs, ultrasound and hysteroscopy.
Frequently asked
Questions people ask.
Quick, plain-English answers to the questions we hear most.
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Is spotting between periods normal?
Occasional spotting is common, especially with hormonal contraception or at ovulation. Persistent spotting should be checked.
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Can the pill cause it?
Yes. Breakthrough bleeding is common in the first months or if pills are missed.
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Could I be pregnant?
It is possible. A pregnancy test is a sensible early step, particularly if you are sexually active.
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Can an infection cause spotting?
Yes, chlamydia and other infections inflame the cervix and can cause bleeding between periods.
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What is ovulation spotting?
Light mid-cycle bleeding some women experience as hormone levels change at ovulation.
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When should I worry?
If spotting persists beyond three months, comes after sex, or is accompanied by pain, discharge or heavy bleeding.
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Do I need an ultrasound?
Often, if bleeding is persistent, to look for polyps, fibroids or thickened lining.
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Can stress cause it?
Stress, weight change and over-exercise can disturb hormones and cause irregular bleeding.
Where this comes from
Sources and checking.
This guide is for information, not medical advice.
Your GP or consultant knows your history and can tell you which parts apply to you. If your symptoms are severe, rapidly worsening, or come with red-flag features, seek urgent medical care. Figures and availability change, so treat them as a guide and confirm with the provider.
Published 2026-10-03, next review 2027-10-03.
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NHS: Chlamydia (nhs.uk/conditions/chlamydia/)
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NICE CKS: Menorrhagia and irregular bleeding (cks.nice.org.uk, topic page)