Bleeding between periods
Bleeding between periods, called intermenstrual bleeding, is not dangerous in most cases. It is still worth checking, because some causes need treatment.
Sometimes normal
Light spotting for a day or two around ovulation, mid-cycle, happens to some people. Spotting in the first few months of a new hormonal birth control method is also common. See bleeding on birth control.
Causes that need attention
- Endometrial or cervical polyps
- Fibroids, especially ones that bulge into the uterine cavity
- Infections of the cervix or uterus, including chlamydia and gonorrhea
- A pregnancy, including an early miscarriage or ectopic pregnancy
- A cesarean scar defect, which often causes spotting after a period ends
- Changes in the cervix found on cervical screening
- Endometrial hyperplasia or cancer, which is uncommon but more likely with age and risk factors
What evaluation usually involves
Expect a pregnancy test, testing for sexually transmitted infections, and a check that your cervical screening is up to date. A pelvic ultrasound looks at the lining and for polyps or fibroids. Sometimes a saline ultrasound or hysteroscopy gives a clearer view of the cavity. An endometrial biopsy is recommended for some people.
Sources
- Munro MG, Critchley HOD, Fraser IS; FIGO Menstrual Disorders Committee. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet. 2018;143(3):393–408.
- American College of Obstetricians and Gynecologists. Practice Bulletin No. 128: Diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol. 2012;120(1):197–206 (reaffirmed).