Bleeding between periods, sometimes referred to as intermenstrual bleeding, means experiencing vaginal bleeding or spotting at a time when you would not normally expect to have your period.
It can range from a small amount of spotting to heavier bleeding and may happen once or repeatedly. There are many possible causes, and in many cases the underlying cause is not serious. However, unexplained or persistent bleeding should always be assessed by a doctor.
At Gynae Solution, we understand that unexpected bleeding can be worrying. Our aim is to identify the cause of your symptoms, explain your options clearly and provide personalised treatment where necessary.
What Is Bleeding Between Periods?
Everyone's menstrual cycle is different, and there is some natural variation in how frequently periods occur and how long they last.
Bleeding between periods is different from your usual menstrual bleeding. You may notice:
- Light spotting between periods
- Pink, red or brown discharge
- Bleeding several days before your period is due
- Bleeding shortly after your period has finished
- Bleeding that occurs repeatedly between periods
- Bleeding following sexual intercourse
Some people may only notice a small amount of blood when wiping, while others may experience bleeding that is more similar to a period.
Bleeding after sex is a related but separate symptom and can also have a number of different causes. Any unexplained bleeding between periods or after sex should be checked by a GP or healthcare professional.
What Causes Bleeding Between Periods?
There are many possible causes of bleeding between periods. Some are temporary and relatively straightforward to treat, while others may require further investigation.
Possible causes include:
Hormonal Contraception
Changes in contraception are a common cause of irregular bleeding. This can occur with the contraceptive pill, implant, injection, patch or intrauterine system (IUS).
Breakthrough bleeding can be particularly common during the first few months after starting or changing hormonal contraception.
Ovulation
Some women experience a small amount of spotting around the time of ovulation. This is usually light and short-lived.
Pregnancy
Bleeding can occur during early pregnancy and may have a number of possible causes. If you have missed a period or there is a possibility you could be pregnant, a pregnancy test may be recommended.
Bleeding accompanied by abdominal or pelvic pain following a missed period requires prompt medical assessment because it can sometimes indicate an ectopic pregnancy.
Infections and Sexually Transmitted Infections
Some infections, including sexually transmitted infections such as chlamydia, can cause bleeding between periods or after sex.
Testing may be recommended if there is a possibility of an infection.
Cervical Changes
Changes affecting the cervix, including cervical ectropion or cervical polyps, can sometimes cause unexpected bleeding, particularly after sexual intercourse.
Fibroids and Polyps
Fibroids are non-cancerous growths that develop in or around the womb. Polyps are small growths that can develop within the lining of the womb or on the cervix.
Both can cause abnormal or irregular bleeding.
Endometriosis
Endometriosis occurs when tissue similar to the lining of the womb grows elsewhere in the body. It can cause painful or heavy periods and, in some people, irregular bleeding.
Polycystic Ovary Syndrome
Polycystic ovary syndrome (PCOS) can affect ovulation and cause periods to become irregular. This can sometimes result in unexpected bleeding.
Perimenopause
Hormonal changes as you approach the menopause can cause changes to your normal menstrual pattern, including irregular or unexpected bleeding.
Less Common Causes
Occasionally, irregular bleeding can be associated with abnormalities affecting the cervix, womb or endometrium. In rare cases, unusual bleeding can be a symptom of a gynaecological cancer.
This does not mean that bleeding between periods is likely to be cancer. There are many more common causes. However, investigating unexplained bleeding is important so that the cause can be identified and appropriate treatment offered.
When Should I See a Doctor?
You should speak to your GP or a healthcare professional if you are experiencing bleeding between periods, particularly if it is:
- New or unusual for you
- Happening repeatedly
- Becoming heavier
- Occurring after sexual intercourse
- Associated with pelvic or abdominal pain
- Associated with unusual vaginal discharge
- Occurring alongside other changes to your menstrual cycle
The NHS recommends that bleeding between periods or after sex is checked by a doctor, even though it is not usually caused by something serious.
If you have missed a period and have unusual bleeding accompanied by abdominal or pelvic pain, seek urgent medical advice.
How Is Bleeding Between Periods Investigated?
The first step is understanding exactly what you are experiencing.
During your consultation, Mr Jafaru Abu will discuss your symptoms and medical history, including:
- When the bleeding started
- How frequently it occurs
- How much bleeding you experience
- Where you are in your menstrual cycle when it occurs
- Whether you experience bleeding after sex
- Any associated pain or other symptoms
- Your contraception and medications
- Your previous gynaecological history
- Your pregnancy history
- Any previous investigations or treatments
Keeping a record of your periods and any unexpected bleeding can be useful when preparing for your appointment. A period diary or app can help identify patterns in your cycle.
Examination
Depending on your symptoms, you may be offered an examination of the vagina and cervix.
This can help identify possible causes such as cervical polyps, cervical ectropion, infection or other abnormalities.
Pregnancy Testing
If there is any possibility of pregnancy, a pregnancy test may be recommended.
Blood Tests
Blood tests may be appropriate depending on your symptoms and medical history. These can help assess your general health and investigate possible underlying causes.
Infection Testing
If an infection or sexually transmitted infection is a possibility, appropriate testing may be recommended.
Ultrasound
An ultrasound scan can provide images of the womb, endometrium, ovaries and surrounding pelvic structures.
It may help identify conditions such as fibroids, ovarian cysts or other abnormalities.
Hysteroscopy
If the symptoms suggest that there may be an abnormality within the cavity of the womb, a hysteroscopy may be recommended.
A hysteroscopy involves passing a small camera through the vagina and cervix so that the inside of the womb can be examined directly. If appropriate, a biopsy or treatment may be carried out at the same time.
Persistent intermenstrual bleeding can be one of the symptoms that leads clinicians to investigate the uterine cavity for conditions such as polyps or endometrial abnormalities.
Colposcopy
If the cervix needs closer examination, you may be referred for a colposcopy. This uses a specialist magnifying instrument to examine the cervix in greater detail and, if necessary, take a small biopsy.
Not everyone will require all of these investigations. The tests recommended will depend on your age, symptoms, medical history and examination findings.
How Is Bleeding Between Periods Treated?
Treatment depends entirely on the underlying cause.
In some cases, no treatment is necessary and the bleeding settles naturally. In other cases, treating the underlying condition can resolve the bleeding.
Treatment may include:
Changing or adjusting contraception
If hormonal contraception is causing breakthrough bleeding, your doctor may discuss whether changing the type of contraception could help.
Treating an infection
If an infection is identified, appropriate medication can usually be prescribed.
Treating polyps or fibroids
If a polyp or fibroid is responsible for the bleeding, treatment may involve monitoring, medication or a procedure to remove it, depending on its size, location and symptoms.
Treating hormonal conditions
If hormonal changes or conditions such as PCOS are contributing to irregular bleeding, treatment can be tailored to the underlying condition.
Surgical treatment
If a structural abnormality is identified or other treatments have not been successful, a surgical procedure may sometimes be recommended.
The most appropriate treatment will depend on the cause of your bleeding and your individual circumstances.
Risks and Benefits of Investigation and Treatment
Investigating unexpected bleeding allows the underlying cause to be identified and helps ensure that appropriate treatment is offered.
Most investigations are straightforward, but some procedures can involve temporary discomfort, cramping or light bleeding.
If treatment is recommended, the benefits will depend on the cause. Treating a polyp, fibroid, hormonal problem or infection, for example, may reduce or stop the abnormal bleeding and improve your quality of life.
Surgical procedures also carry potential risks, such as bleeding, infection or complications associated with anaesthesia. The specific risks will depend on the procedure being considered.
Before recommending any investigation or treatment, Mr Abu will explain the options available to you, including the potential benefits, risks and alternatives.
Specialist Care for Bleeding Between Periods
Unexpected bleeding can be unsettling, particularly when you do not know why it is happening. The good news is that there are many possible causes, and most are not serious.
The important thing is not to ignore persistent or unexplained bleeding.
At Gynae Solution, Mr Jafaru Abu will take the time to understand your symptoms, investigate the possible causes and explain your options in clear, straightforward language.
If you are experiencing bleeding between periods, bleeding after sex or a change in your usual menstrual pattern, contact Gynae Solution to arrange a consultation.
Common questions
How soon can I be seen?
Daily appointments are available at The Park Hospital. Call the secretary on 0115 966 2049, or send an enquiry below and we will reply within 24 hours on business days.
Do I need a GP referral?
Referrals from GPs are welcome, and you can also enquire directly. If you are using private medical insurance, check with your insurer whether a referral is required for your policy. See GP referrals and fees and insurance.
What does a consultation cost?
A new consultation is £250 and a follow-up consultation is £150. The cost of any tests, procedures or surgery is quoted individually after your consultation. See fees and insurance.
Enquiries
Send us a message
Enquiries from patients and referring clinicians are both welcome. We endeavour to answer all enquiries within 24 hours on business days. If your case is urgent, please say so in your message or call the secretary directly.