Bleeding Between Periods

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Try one of these related symptoms.

Bleeding between periods

Bloody vaginal discharge

Bleeding after menopause

Implantation bleeding

Brown spotting between periods

Bleeding after period ends

Bleeding 2 weeks after period

About the Symptom

Bleeding that occurs in between a normal menstrual cycle. Irregular and unpredictable period bleeding is considered abnormal and should be investigated.

When to See a Doctor

Seek professional care if you experience any of the following symptoms

Possible Causes

Generally, Bleeding between periods can be related to:

Related Serious Diseases

Sometimes, Bleeding between periods may be related to these serious diseases:

Doctor's Diagnostic Questions

Your doctor may ask these questions to check for this symptom:

Reviewed By:

Ravi P. Chokshi, MD

Ravi P. Chokshi, MD (Obstetrics and Gynecology (OBGYN), Critical Care)

Current Maternal Fetal Medicine Fellow with Dual board certification in Obstetrics & Gynecology and Critical Care Medicine. | 5+ years experience managing a general Ob/Gyn practice and working in the Intensive Care Unit. | Previously Physician Lead of a large single specialty practice with 8 Physicians and 10+ Advanced practitioners. | Member of the Society of Maternal Fetal Medicine Patient education committee. | Frequent Medscape Consult contributor.

Seiji Kanazawa, MD, PHD

Seiji Kanazawa, MD, PHD (Obstetrics and Gynecology (OBGYN))

Dr. Kanazawa graduated from the Niigata University Faculty of Medicine and received his Ph.D. from the Tohoku University Graduate School of Medicine. He is working on the front line of the General Perinatal Center, including the Tokyo Tama General Medical Center and the National Center for Research in Fertility Medicine, where he provides maternal and fetal care and undertakes clinical research. At Ubie, Dr. Kanazawa has been designing the Ubie AI Symptom Checker and has taken on the role of general obstetrics and gynecology consultation at FMC Tokyo Clinic by providing fetal ultrasound and prenatal consultation.

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Content updated on Feb 6, 2025

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FAQs

Q.

Abnormal Bleeding? Why Hysteroscopy is Key & Medically Approved Next Steps

A.

Abnormal uterine bleeding is best evaluated with hysteroscopy, a safe, minimally invasive procedure that lets doctors directly see the uterine lining and often treat causes like polyps, submucosal fibroids, adhesions, thickened lining, or early cancer. Most causes are treatable, and hysteroscopy enables targeted biopsy or same-visit removal when appropriate. Next steps vary by findings, from hormonal therapies to polyp or fibroid removal, with urgent evaluation needed for very heavy or any postmenopausal bleeding; there are several factors to consider. See the complete guidance below for who should get hysteroscopy, what to expect, risks, alternatives, and when to seek emergency care.

References:

* Di Spiezio Sardo, A., et al. "Hysteroscopy for Abnormal Uterine Bleeding: Why, When, and How." *Journal of Minimally Invasive Gynecology*, vol. 28, no. 1, Jan. 2021, pp. 31-39. *PubMed*, doi:10.1016/j.jmig.2020.07.009.

* Hovav, Y., et al. "The role of hysteroscopy in evaluation of abnormal uterine bleeding: a literature review." *International Journal of Women's Health*, vol. 11, 27 June 2019, pp. 395-403. *PubMed*, doi:10.2147/IJWH.S205218.

* Vilos, G. A., and E. T. Vilos. "Hysteroscopy in the Diagnosis and Management of Abnormal Uterine Bleeding." *Journal of Minimally Invasive Gynecology*, vol. 30, no. 4, Apr. 2023, pp. 259-270. *PubMed*, doi:10.1016/j.jmig.2023.01.002.

* Ceci, O., et al. "Diagnostic value of hysteroscopy for abnormal uterine bleeding in perimenopausal and postmenopausal women." *Menopause*, vol. 24, no. 1, Jan. 2017, pp. 80-86. *PubMed*, doi:10.1097/GME.0000000000000720.

* Wouk, N., and J. H. Blatner. "Management of abnormal uterine bleeding in reproductive-aged women." *American Family Physician*, vol. 102, no. 9, 1 Nov. 2020, pp. 541-549. *PubMed*, PMID: 33151121.

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Q.

Bleeding on the Birth Control Implant? The Science & Medical Next Steps

A.

Irregular bleeding on the birth control implant is very common and usually not dangerous, caused by progestin thinning the uterine lining, and it does not mean the implant is failing. There are several factors to consider; see below to understand more. Seek care urgently for heavy bleeding, severe pain, pregnancy signs or infection; short term treatments like NSAIDs or a brief course of combined pills or estrogen can reduce bleeding, removal is reasonable if it impacts your life, pregnancy including ectopic is rare but test if concerned, and other conditions like STIs or fibroids may also cause bleeding, with more guidance below.

References:

* Bahamondes L, Olavide Y, Pimentel Gomes L, et al. Etonogestrel-releasing implants: a systematic review on bleeding patterns, side effects, and patient satisfaction. Contraception. 2020 Feb;101(2):77-88.

* Merki-Feld GS, Breidert M. Etonogestrel implant: Clinical considerations and patient management. Expert Rev Clin Pharmacol. 2017 Dec;10(12):1283-1296.

* Blumenthal PD, Darney PD. Managing the progestin-only implant: a guide for clinicians. Contraception. 2015 Dec;92(6):531-9.

* Darney PD, Patel A, Creinin MD, et al. Management of unscheduled bleeding with progestin-only contraception. Contraception. 2014 Dec;90(6 Suppl):S12-23.

* Mansour D, Korver T, Marintcheva-Sakalieva A, et al. Irregular uterine bleeding associated with hormonal contraception: clinical implications and management. Contraception. 2012 May;85(5):427-38.

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Q.

Brown Discharge but No Period? Why Your Body is Spotting & Medical Next Steps

A.

There are several factors to consider: brown discharge without a period is usually old blood leaving slowly and is often linked to normal cycle changes, hormonal shifts, or birth control, but it can also happen with ovulation or early pregnancy. Take a pregnancy test if there is any chance, track timing and symptoms, and seek care if spotting persists, is painful, foul-smelling, heavy, follows sex, or occurs after menopause. See below for important details on infections, PCOS, uterine or cervical conditions, and the exact next steps a clinician may recommend, which could change what you do next.

References:

* pubmed.ncbi.nlm.nih.gov/30419253/

* pubmed.ncbi.nlm.nih.gov/34685141/

* pubmed.ncbi.nlm.nih.gov/31855913/

* pubmed.ncbi.nlm.nih.gov/27068212/

* pubmed.ncbi.nlm.nih.gov/28552174/

See more on Doctor's Note

Q.

Brown Discharge but No Period? Why Your Body Is Spotting & Medical Next Steps

A.

There are several factors to consider: brown discharge without a period is usually old blood and is often due to hormonal shifts, birth control, ovulation, or early pregnancy, but it can also be linked to infections, PCOS, perimenopause, polyps or fibroids, and rarely ectopic pregnancy or other serious issues. For the right next steps, see the complete guidance below, including when to take a pregnancy test, what symptoms to monitor, and when to seek urgent care for severe pain, heavy bleeding, fever, dizziness, or a positive test with pain.

References:

* Jha S, et al. Intermenstrual bleeding: a systematic review of causes, diagnosis and management. BJOG. 2021 Jul;128(8):1378-1386. doi: 10.1111/1471-0528.16709. Epub 2021 Apr 22. PMID: 33818816.

* Singh S, et al. Early pregnancy bleeding: a narrative review. Women Health (Lond). 2023 Jul;19(2):169-183. doi: 10.1177/17455065231180016. PMID: 37470691.

* Abdel-Rahman YM, et al. Breakthrough bleeding in women using hormonal contraception: a systematic review. Contraception. 2021 Sep;104(3):284-290. doi: 10.1016/j.contraception.2021.05.006. Epub 2021 May 26. PMID: 34052309.

* Anastasiadis A, et al. Endometrial Polyps and Abnormal Uterine Bleeding: A Review. Int J Environ Res Public Health. 2022 Mar 22;19(6):3745. doi: 10.3390/ijerph19063745. PMID: 35323719; PMCID: PMC8955212.

* Vilanilam G, et al. Abnormal uterine bleeding in non-gravid women: a pictorial review. Insights Imaging. 2020 Feb 28;11(1):28. doi: 10.1186/s13244-020-00827-x. PMID: 32107567; PMCID: PMC7048701.

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Q.

Brown Discharge But No Period? Why Your Body Is Spotting & Medical Next Steps

A.

Brown discharge without a period is usually old blood and can be normal near your period or ovulation, or linked to hormonal changes, birth control, or early pregnancy. There are several factors to consider; less common causes include infection, fibroids or polyps, and rarely cancer, so see the complete details below. Next steps: monitor if brief with no other symptoms, take a pregnancy test if possible, and contact a clinician for spotting that persists or recurs, has a foul odor, or comes with pain, fever, bleeding after sex or after menopause, heavy bleeding, dizziness, or fainting.

References:

* Sassarini J, et al. Abnormal uterine bleeding in reproductive-aged women: an overview of the causes, diagnosis and management. Best Pract Res Clin Obstet Gynaecol. 2022 Dec;85(Pt B):104-116. PMID: 36058694.

* Dziubanov A, et al. Bleeding in early pregnancy: causes, diagnosis, and management. Curr Opin Obstet Gynecol. 2023 Dec 1;35(6):629-636. PMID: 37785535.

* Kaneshiro B, et al. Breakthrough bleeding with contraceptive use. Curr Opin Obstet Gynecol. 2022 Dec 1;34(6):533-539. PMID: 36130325.

* Mitchell C, et al. Diagnosis and Management of Vaginitis. Obstet Gynecol. 2021 May 1;137(5):896-905. PMID: 33830913.

* Pinkerton JV. Abnormal Uterine Bleeding in Perimenopause. J Clin Endocrinol Metab. 2020 Jul 1;105(7):dgaa208. PMID: 32338782.

See more on Doctor's Note

Q.

Brown Discharge But No Period? Why Your Body Is Spotting & Medical Next Steps

A.

Brown discharge without a period is usually old blood and can be normal around the start or end of a cycle, with ovulation, after changes in birth control, with stress or hormonal shifts, early pregnancy, or perimenopause. There are several factors to consider; see below for causes, timing clues, and what they mean for your next steps. Seek care urgently or promptly if spotting is persistent or heavy, painful, foul smelling, occurs after sex or after menopause, or if you have fever, a late period with a positive test, pelvic or shoulder pain, dizziness, or other pregnancy concerns. Full guidance on when to watch and when to call a clinician, plus testing and treatment options, is provided below.

References:

* American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 191: Abnormal Uterine Bleeding. Obstet Gynecol. 2018 Jan;131(1):e1-e12. doi: 10.1097/AOG.0000000000002447. PMID: 29377898.

* Gallo MF, Grimes DA, Schulz KF. Managing breakthrough bleeding and spotting in women using hormonal contraception. Cochrane Database Syst Rev. 2014 Mar 5;(3):CD007134. doi: 10.1002/14651858.CD007134.pub5. PMID: 24584090.

* Hasan R, Baird DD, Herring AH, Olshan AF, Jonsson Funk M, Hartmann KE. Vaginal bleeding in early pregnancy: Incidence, outcome, and risk factors. Paediatr Perinat Epidemiol. 2017 Nov;31(6):528-538. doi: 10.1111/ppe.12411. Epub 2017 Oct 16. PMID: 29033320; PMCID: PMC5660856.

* Goldstein SR. Abnormal Uterine Bleeding in Perimenopause. J Clin Med. 2022 Jun 29;11(13):3768. doi: 10.3390/jcm11133768. PMID: 35790833; PMCID: PMC9268388.

* Stamellou A, Tsamandas AC, Ioannidis A, Vaxevanidou A, Tsironi E, Stamboulis K. Cervical Polyps: A Review. Diagnostics (Basel). 2021 Mar 24;11(3):580. doi: 10.3390/diagnostics11030580. PMID: 33807208; PMCID: PMC8001648.

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Q.

Brown Discharge but No Period? Why Your Body is Spotting & Medically Approved Next Steps

A.

There are several factors to consider: brown discharge without a period is most often old blood, but it can also result from hormonal shifts, ovulation, recent birth control changes, early pregnancy, infections, PCOS, fibroids, or perimenopause, with rare but serious causes like ectopic pregnancy or cervical or uterine cancer. See below to understand more. Next steps include taking a pregnancy test if your period is late, tracking timing and symptoms, reviewing contraception changes, and seeking urgent care for severe pain, heavy bleeding, fever, foul odor, a positive test with pain, or any postmenopausal spotting; complete guidance and key nuances that could change your next steps are outlined below.

References:

* ACOG Practice Bulletin No. 209: Abnormal Uterine Bleeding. Obstet Gynecol. 2019 Jul;134(1):e1-e24. PMID: 31343644.

* Whitaker L, Karjane N. Abnormal Uterine Bleeding: An Overview for the Healthcare Professional. Prim Care. 2020 Dec;47(4):531-542. PMID: 33423405.

* Hickey M, et al. Intermenstrual bleeding: aetiology, diagnosis and management. Best Pract Res Clin Obstet Gynaecol. 2017 Nov;45:33-46. PMID: 28823862.

* Litta P, et al. Uterine polyps and abnormal uterine bleeding. Minerva Ginecol. 2018 Jun;70(3):314-320. PMID: 29758778.

* El-Naggar A, et al. Early pregnancy bleeding: diagnosis and management. Curr Opin Obstet Gynecol. 2020 Aug;32(4):246-252. PMID: 32620713.

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Q.

Heavy Bleeding? How Tranexamic Acid Works & Your Medical Next Steps

A.

Heavy bleeding relief with tranexamic acid: a nonhormonal medicine that helps clots last longer to reduce flow, usually taken only during days of bleeding and often cutting blood loss by 30 to 60 percent. There are several factors to consider, including that it treats symptoms rather than the cause, who should not take it such as people with blood clot risks or serious kidney disease, possible side effects, and urgent red flags like soaking pads hourly, feeling faint, or possible pregnancy; see below for complete guidance on dosing, tests to find the cause, alternative treatments, and your next steps.

References:

* Khan, R. D., & Choonara, I. (2019). Tranexamic Acid: An Update on Its Mechanism of Action and Clinical Efficacy. *Medical Sciences*, *7*(7), 99. PMID: 31252601.

* McCormack, P. L. (2016). Tranexamic Acid: A Critical Review of Its Use in Medical Disorders. *Clinical Therapeutics*, *38*(10), 2340–2357. PMID: 27751680.

* Lethaby, A., & Farquhar, C. (2021). Tranexamic acid for heavy menstrual bleeding. *Cochrane Database of Systematic Reviews*, *(3)*. PMID: 33660383.

* Sentilhes, L., Vayssière, C., Deneux-Tharaux, C., Aya, A. G., Bayoumeu, F., Bonnet, M. P., ... & Groupe de Recherche en Obstétrique et Gynécologie (GROG). (2019). Tranexamic acid in postpartum hemorrhage: A critical review. *International Journal of Gynecology & Obstetrics*, *144*(1), 6–12. PMID: 30382587.

* Le Mars, J. A., & Binks, S. (2018). Tranexamic acid for trauma: A review of the current literature. *Journal of Clinical Anesthesia*, *49*, 10–14. PMID: 29734914.

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Q.

Is This Implantation Bleeding? Why You’re Spotting & Medical Next Steps

A.

Light spotting that is pink or brown, very light, and lasts hours to 1 to 2 days about 6 to 10 days after ovulation can be implantation bleeding, while heavier red flow with clots and increasing cramps is more like a period. There are several factors to consider, including other causes like hormonal shifts, ovulation spotting, cervical irritation, infections, fibroids, and pregnancy complications, plus when to time a pregnancy test for accuracy. See the complete guidance below, including urgent red flags like heavy bleeding, severe or one-sided pain, shoulder pain, dizziness, or fainting that need immediate care, to decide your next steps.

References:

* Ali S, et al. Early pregnancy bleeding: diagnosis and management. BMJ. 2017 Aug 16;358:j3608. doi: 10.1136/bmj.j3608. PMID: 28814407.

* Hasan R, et al. Patterns of bleeding in early pregnancy and risk of miscarriage. Obstet Gynecol. 2010 Sep;116(3):614-21. doi: 10.1097/AOG.0b013e3181ec20f4. PMID: 20733441.

* Barnhart KT, et al. Management of early pregnancy bleeding. Obstet Gynecol. 2020 Dec;136(6):1121-1134. doi: 10.1097/AOG.0000000000004183. PMID: 33230006.

* Ponzano A, et al. Vaginal bleeding in early pregnancy: When to worry? Best Pract Res Clin Obstet Gynaecol. 2022 Jan;78:29-41. doi: 10.1016/j.bpobgyn.2021.09.006. PMID: 34972740.

* Schroeder L, et al. Pregnancy, Bleeding. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32491566.

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Q.

Is It Implantation Bleeding? Why You’re Spotting Early & Medically Approved Next Steps

A.

Light, short-lived pink or brown spotting about 6 to 12 days after ovulation can be implantation bleeding, but it is less common than many expect and often mistaken for an early period. There are several factors to consider, including timing, flow, and symptoms; test on the first day of a missed period and seek urgent care for heavy bleeding, severe pain, dizziness, or shoulder pain. See below for complete, medically approved next steps and key details that could change what you do next.

References:

* Koopman C, Bleiberg B, Peleg D, Melnikov S. Vaginal bleeding in early pregnancy. Am Fam Physician. 2021 Mar 15;103(6):353-360. PMID: 33720760.

* Vathanan V, Lumsden MA, van der Spuy ZM. Vaginal bleeding in the first trimester of pregnancy: a practical guide. BJOG. 2018 Sep;125(10):e1-e11. PMID: 29969677.

* Jurkovic D, Overton C, Bender-Atik R. Early pregnancy assessment and management of bleeding and pain. Best Pract Res Clin Obstet Gynaecol. 2013 Aug;27(4):593-605. PMID: 23746682.

* Gulumser C, Akyol D, Duran B. The incidence and clinical significance of self-reported bleeding during early pregnancy. J Turk Ger Gynecol Assoc. 2018 Dec 28;19(4):203-207. PMID: 30295610.

* Cheah PP, Tang MI, Sivalingam VN, Tan PC. The role of the early pregnancy assessment unit in the diagnosis and management of early pregnancy complications. Aust N Z J Obstet Gynaecol. 2018 Oct;58(5):490-495. PMID: 29388145.

See more on Doctor's Note

Q.

Implantation Bleeding: Signs for Women 30-45 & Vital Next Steps

A.

Implantation bleeding in women 30 to 45 is usually light pink or brown spotting 6 to 12 days after ovulation, a few days before a missed period, lasting only hours to 1 to 2 days without increasing flow. If you are in this age range, consider other common causes like perimenopause, fibroids, thyroid problems, or birth control effects, take a pregnancy test when your period is late or at least 14 days after ovulation, and seek urgent care for heavy bleeding, severe pelvic or shoulder pain, dizziness, or fainting. There are several factors to consider; key differences from a period, timing tips, and vital next steps and red flags are detailed below.

References:

* Harville, E. W., Wilcox, A. J., Baird, D. D., & Weinberg, C. R. (2003). Predictors of first-trimester bleeding in a prospective cohort study. *Human Reproduction*, 18(1), 183-189.

* Bor, P., Dhaese, R., & Denckels, W. (2020). First trimester bleeding in women with an intrauterine pregnancy: A literature review. *European Journal of Obstetrics & Gynecology and Reproductive Biology: X*, 7, 100096.

* Barnhart, K. T., Sammel, M. D., Rinaudo, P., & Takacs, P. (2003). First trimester bleeding: a review of the etiology and significance. *Obstetrical & Gynecological Survey*, 58(9), 619-627.

* Committee on Practice Bulletins—Obstetrics. (2018). ACOG Practice Bulletin No. 200: Early Pregnancy Loss. *Obstetrics & Gynecology*, 132(5), e197-e207.

* Rostin, S., & von Dadelszen, P. (2016). Management of common symptoms and complaints during pregnancy. *Best Practice & Research Clinical Obstetrics & Gynaecology*, 36, 1-13.

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Q.

Brown Discharge but No Period—Pregnancy, Ovulation, or Something Else?

A.

There are several factors to consider; brown discharge without a period is usually old blood and can stem from implantation or early pregnancy, ovulation spotting, recent birth control changes, perimenopause, infections, or less commonly fibroids, polyps, or other uterine or cervical conditions. Watch for red flags like heavy bleeding, severe pain, fever or foul odor, dizziness or fainting, or one sided pelvic pain with pregnancy, and see below for exact timelines, when to test for pregnancy or STIs, how to track symptoms, and other details that can guide your next steps.

References:

Munro MG, Critchley HOD, Broder MS, & Fraser IS. (2011). The FIGO systems for normal and abnormal uterine bleedin… Int J Gynaecol Obstet, 25907116.

Practice Committee of the American Society for Reproductive Medicine. (2008). Definitions in reproductive medicine: abnormal uterine bleedin… Fertil Steril, 18480389.

Castera L, Foucher J, Bernard PH, Carvalho F, Allaix D, Merrouche W, Couzigou P, & de Ledinghen V. (2005). Prospective comparison of transient elastography, FibroTest… Gastroenterology, 16023524.

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Q.

For Teens: Brown Discharge but No Period—Is It Normal?

A.

It is usually normal and simply old menstrual blood, especially in the first years of periods; common causes include anovulatory cycles, normal hormone shifts, birth control changes, implantation spotting if sexually active, mild infections, and less commonly PCOS or thyroid issues. There are several factors to consider, and warning signs like heavy bleeding, severe pain, fever, strong odor, or spotting over 7 days should prompt care. See complete details below for what to track, possible tests and treatments, and how to choose the right next steps.

References:

Frishman GN, & Johnson PN. (2016). The evaluation and management of adolescents with abnormal uterine bleeding… Journal of Pediatric and Adolescent Gynecology, 27507604.

Tapper EB, & Lok AS. (2017). Transient elastography for the assessment of liver fibrosis and cirrhosis… Hepatology, 28318460.

Bosch J, & Abraldes JG. (2015). Diagnosis and management of cirrhosis and its complications… Journal of Hepatology, 25594860.

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Q.

Why am I spotting 1 week after my period?

A.

One week after your period ends is the time of ovulation or release of an egg. You may get some lighter bleeding due to hormonal shifts that happen after your period.

References:

Sweet MG, Schmidt-Dalton TA, Weiss PM, Madsen KP. Evaluation and management of abnormal uterine bleeding in premenopausal women. Am Fam Physician. 2012 Jan 1;85(1):35-43. PMID: 22230306.

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References