Light bleeding or a few spots of blood between periods is something many women notice and then quietly decide to ignore. It is common to wonder whether it is normal, whether you caused it, and whether it is worth a visit. It is worth asking, and the cause can usually be found.
Bleeding between periods is a symptom, not a diagnosis. Hormonal changes are a frequent reason, including starting, stopping or missing a contraceptive pill, an implant or hormone therapy, and the first months of a new method often bring unscheduled bleeding. Other possibilities include a polyp or fibroid in the uterus, a change at the cervix, an infection, or a pregnancy, including one that is not in the right place. Thyroid problems and clotting disorders can also play a part. Because the list is long and the treatments are different, guessing from the pattern alone is not reliable.
Ask whether you need to be seen
Message us with what you are experiencing and we will tell you whether an examination is worth making, and what the appointment involves.
WhatsAppLINEWhat matters most is whether it has changed from your own normal. A single episode after a very late period or a change of pill is different from spotting that comes back cycle after cycle, appears after sex, or begins when your periods have already become heavier or longer. You do not need to wait for it to become heavy before it counts.
Assessment starts with listening: when it began, how much, how it relates to your cycle and to sex, what contraception or hormones you use, and whether there is pain or discharge. A pregnancy test may be suggested, followed by an examination and usually a pelvic ultrasound, which shows the lining of the uterus, fibroids and polyps. Blood tests are added where they help, and where the lining needs a closer look, a sample can often be taken in the clinic. You can ask for each step to be explained beforehand, and to pause at any point.
The options follow the cause. If a hormonal method is the reason, it may be adjusted or changed. A polyp or fibroid has its own plan, which may be watching, medicine or a procedure, discussed with you after the findings. An infection is treated as an infection. Results differ between individuals, and no outcome is guaranteed.
See a doctor sooner if any bleeding happens after menopause, after sex, or during a pregnancy or when you might be pregnant, which should be checked the same day. The same applies if bleeding soaks protection hour after hour, comes with dizziness, fainting, severe pain or fever, or if spotting keeps returning for more than a couple of cycles.
If this has been on your mind, send us a few lines on WhatsApp or LINE about what you are noticing, in your own words, including when it happens and what contraception you use. The team will reply with whether an examination is worth making and what the appointment involves, and you do not need to feel awkward about the details. Consultations are in Thai or English at EMSPHERE, next to BTS Phrom Phong.