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What's causing my bleeding between periods?

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What causes bleeding between periods, what is spotting, and when might you want to talk to a doctor about it? Dr Rhianna McClymont, Lead GP at Livi, explains

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Bleeding in between your periods is common and usually not something to worry about. But what exactly does it mean?

‘Spotting is very light vaginal bleeding that happens outside of your regular periods,’ says Dr Rhianna McClymont. ‘You might only notice blood on your toilet roll or underwear, and it doesn’t usually require a tampon or pad for protection.’

How long does a period last?

‘A period bleed is your typical menstrual cycle bleed, which normally lasts about 5 days,’ says Dr McClymont. ‘Most people have a regular bleed approximately every 28 days, although some people naturally have a more irregular cycle.

‘It’s common for a few days of this bleed to be a heavy flow of blood and a few days to be very light bleeding at the end of your period. Spotting, on the other hand, is bleeding in between your menstrual cycle bleeds.’

So, what causes bleeding between periods?

There are a number of reasons why you might experience spotting, and some of them aren’t necessarily a cause for concern. It’s always a good idea to talk to a doctor about spotting that’s new and unusual for you.

1. Starting a new hormonal contraception

‘Spotting isn’t uncommon when you start a new hormonal contraception,’ says Dr McClymont. ‘Usually, this spotting stops spontaneously after a few weeks or months.’ It’s also common to experience spotting if you miss a dose of the contraceptive pill.

‘However, if you’re experiencing new spotting that’s developed after you’ve been using a contraceptive for a few months, when you haven’t previously experienced bleeding between periods, and when you haven’t missed any doses, you should speak to a doctor,’ adds Dr McClymont.

2. STIs

Sexually transmitted infections can cause spotting,’ says Dr McClymont. ‘There may be other accompanying symptoms such as vaginal discharge, pain while peeing or abdominal pain, too.’

3. Pregnancy

‘Spotting in pregnancy is also common,’ says Dr McClymont. ‘This usually happens during early pregnancy – around the time of implantation and during the first trimester.

‘If the spotting develops into a heavier flow or is accompanied by abdominal or pelvic pain, you should talk to a doctor as this may be an indication of a miscarriage.’

4. Ovulation

Some of us experience spotting mid-cycle, around the time of ovulation. ‘This is usually very light spotting for a short time and can be identified if you’re tracking ovulation within your cycle,’ says Dr McClymont.

5. Fibroids and polyps

‘Both fibroids and polyps can cause spotting,’ says Dr McClymont. ‘This may be accompanied by heavier periods, or in some cases pelvic pain, but many people get no other symptoms.’

6. Problems with the cervix

If you ever experience spotting after having sex, be sure to speak with a doctor – it can be a sign that there could be a problem with the cervix.

‘Often, changes with the cervix are completely benign. For example, an ectropion is when a growth of fragile cells that normally reside on the inside of the cervix move to the outside. These cells can bleed easily, particularly after sex,’ Dr McClymont explains.

7. Gynaecological cancers

Gynaecological cancers affecting the cervix, vulva or lining of the womb can cause spotting, which is why you should always take spotting that’s unusual for you seriously.

If you have:

  • Bleeding between periods
  • Spotting after sex
  • Spotting after you’ve gone through the menopause
  • New spotting after being stable on hormonal contraception or HRT for a while
  • A non-healing rash or ulcer in your vulva or vagina
  • Persistent vaginal itching or pain
  • Anything else that concerns you in your genital region

...then it’s important to get this reviewed by a doctor.

What if I’m nervous about discussing spotting with my GP?

It’s natural to feel embarrassed or nervous about the thought of a genital exam, but there’s no need, Dr McClymont reassures. ‘Spotting is a common problem to discuss with a doctor,’ she says. ‘It’s important to remember that having an examination can help set your mind at rest and avoid long-term health problems.’

Dr McClymont also stresses the importance of having a cervical screening test. ‘This will not be done as an investigation for spotting as it’s a screening test only, but it’s important to attend whenever you’re called to catch problems with the cervix early.’

This article has been medically approved by Dr Rhianna McClymont, Lead GP at Livi.

See a GP about spotting

If you’re experiencing spotting that’s new for you or any other related symptoms that worry you, make an appointment to speak to a doctor.

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