Quick answer: Spotting between periods is light bleeding outside your normal period. It is often harmless, caused by ovulation, hormonal contraception or a missed pill. It can also come from polyps, infection, pregnancy or changes in the cervix or uterine lining, so spotting that keeps recurring, or happens after sex or menopause, should be checked.
Key takeaways
- Occasional mid-cycle spotting around ovulation or on new contraception is common.
- Polyps, cervical ectropion and infections such as chlamydia are frequent treatable causes.
- Spotting after sex, after menopause or that keeps returning needs a gynaecological check.
- A pregnancy test, cervical screening, swabs and a transvaginal ultrasound are the first tests.
- Hysteroscopy lets the doctor see and remove polyps in the same short procedure.
What causes spotting between periods?
Spotting between periods (intermenstrual bleeding) usually has a hormonal or local cause in the cervix or uterus. The most common causes are listed below.
Hormonal causes
- Ovulation spotting: a little pink or brown discharge mid-cycle as oestrogen dips briefly.
- Hormonal contraception: breakthrough bleeding is common in the first three months of a pill, implant, injection or hormonal IUD, and after missed pills.
- Irregular ovulation: in PCOS, thyroid disorders or perimenopause.
Structural causes
- Endometrial and cervical polyps: soft, usually benign growths that bleed easily, especially after sex.
- Fibroids: particularly those close to the lining.
- Cervical ectropion: a harmless area of delicate cells on the cervix that can bleed on contact.
Infection and inflammation
Chlamydia, gonorrhoea and other infections can inflame the cervix and cause spotting, often with discharge or pelvic pain. Treating the infection early protects future fertility.
Pregnancy-related causes
Light bleeding can occur in early pregnancy, but bleeding with pain may signal a miscarriage or ectopic pregnancy. Always take a pregnancy test if there is any chance you could be pregnant.
Concerning changes
Less commonly, spotting is caused by endometrial hyperplasia, precancerous changes of the cervix or, rarely, cancer. These are more likely over 45, after menopause, with obesity, or without up-to-date cervical screening.
Is it a benign polyp or something more serious?
Most causes of spotting are benign, but only an examination and tests can confirm it. The table shows how the common causes differ.
| Cause | Typical pattern | How it is confirmed | Usual treatment |
|---|---|---|---|
| Ovulation spotting | Mid-cycle, 1 to 2 days, very light | Cycle tracking | None needed |
| Contraception | First 3 months, or after missed pills | History | Wait, or change method |
| Polyp | Irregular spotting, bleeding after sex | Ultrasound, hysteroscopy | Hysteroscopic removal |
| Cervicitis or infection | Spotting with discharge or pain | Swabs | Antibiotics, partner treatment |
| Cervical precancer | Bleeding after sex | Pap smear, HPV test, colposcopy | Local treatment of the cervix |
| Endometrial hyperplasia | Irregular or heavy bleeding, often over 45 | Ultrasound, biopsy | Progestogen therapy or surgery |
How is spotting between periods diagnosed?
- History: when the spotting happens, its link to sex or contraception, and your cycle pattern.
- Pregnancy test.
- Speculum examination: to look at the cervix for polyps, ectropion or inflammation.
- Cervical screening: Pap smear and/or HPV test if due.
- Swabs for infection.
- Transvaginal ultrasound: to check the lining, polyps and fibroids.
- Hysteroscopy or endometrial biopsy if bleeding persists or the lining looks abnormal.
How does hysteroscopy help with spotting?
Hysteroscopy uses a thin telescope passed through the cervix to look directly inside the uterus. No cut is made on the abdomen.
- It is usually done soon after a period, under local anaesthesia or short general anaesthesia depending on the procedure.
- The uterus is gently filled with fluid so the doctor can see the lining clearly.
- Polyps or small fibroids can be removed in the same sitting, and tissue is sent for testing.
- Most women go home the same day and return to normal activities within one or two days.
Learn more about hysteroscopy and endometrial and cervical polyps.
What is the treatment for spotting between periods?
Treatment depends entirely on the cause. Contraceptive spotting often settles with time or a change of method. Infections are treated with antibiotics, and partners may need treatment too. Polyps are removed hysteroscopically. Cervical precancer is treated locally after colposcopy. Hormonal causes are managed by correcting thyroid or prolactin levels, or with hormonal regulation of the cycle.
If your spotting is part of a wider pattern of abnormal bleeding, see our guides on abnormal uterine bleeding and the complete guide to period issues.
When to see a gynaecologist
- Spotting that happens in two or more cycles.
- Bleeding after sex.
- Any bleeding after menopause.
- Spotting with pelvic pain, fever or unusual discharge.
- Bleeding with a positive pregnancy test, especially with pain (seek urgent care).
- Overdue cervical screening.
How Dr. Divya Venugopalan can help
Dr. Divya Venugopalan, gynaecologist in Bengaluru, evaluates spotting with an examination, cervical screening and ultrasound, so the cause is identified rather than guessed.
Her FMAS training in minimal access surgery allows her to perform diagnostic and operative hysteroscopy to remove polyps in a short day-care procedure. She also offers HPV vaccination and cervical screening as part of her gynaecology care.
Book an appointment at Thanisandra, Sahakar Nagar or HRBR Layout.
Frequently asked questions
Can stress cause spotting between periods?
Stress can disturb ovulation and lead to irregular bleeding or spotting. However, it should not be assumed to be the cause until a doctor has excluded polyps, infection and cervical changes.
Is spotting between periods a sign of cervical cancer?
Rarely. Most spotting has a benign cause. Bleeding after sex or between periods is one reason to check the cervix, so keep cervical screening up to date and see a doctor if spotting persists.
Will a polyp come back after hysteroscopic removal?
Most polyps do not return after complete removal, but new ones can form over time, especially with hormonal factors. Report any new spotting to your doctor.
Is spotting normal on the pill?
Yes, especially in the first three months or after missed pills. If it continues beyond three months or starts after a long time on the same pill, get it checked.
Is spotting after sex normal?
Occasional spotting can happen after vigorous sex, but repeated bleeding after sex is not normal. It can be caused by polyps, infection, ectropion or cervical changes and should be examined.
Medically reviewed by: Dr. Divya Venugopalan, MBBS, DNB (OBG), FRM, FMAS. Gynaecologist & fertility specialist, Bengaluru (KMC Reg. No. 91293). Last reviewed: 27 October 2026.
This article is for general information and does not replace a personal consultation. In an emergency, visit the nearest hospital emergency department.
