Bleeding in between periods? Spotting and other abnormal bleeding explained.
Spotting outside your period isn’t random or “just your body being weird.”
What Counts as Abnormal Bleeding?
A normal menstrual cycle is usually between 26–34 days, with bleeding lasting 3–5 days. When bleeding happens outside this window—before, during, or after—it’s a sign your hormones or reproductive system may need attention.
The most common bleeding patterns I see in clinic are:
Spotting before your period starts (1–3 days of brownish bleeding)
Bleeding mid-cycle (lighter spotting or sometimes a heavier bleed)
A period that feels never-ending (lasting 7–14 days, with only short breaks)
Bleeding after sex
This type of bleeding can be disruptive and exhausting. It affects not only your lifestyle—sex, socialising, even leaving the house—but also your health.
The Physical Effects of Extra Bleeding
Low iron and B12 → leading to fatigue, brain fog, depression, and low motivation
Vaginal health issues → increased risk of thrush or BV, as excess blood changes vaginal pH
Anxiety and stress → worrying about constant spotting or leaks can take a huge emotional toll
Why Am I Bleeding Between Periods?
There are many reasons spotting can occur. Often, it’s a combination of factors. The most common include:
1. Hormonal Imbalances
High oestrogen: Oestrogen builds the uterine lining. If levels are too high, the lining may overgrow, causing heavier or prolonged bleeding. Signs include breast tenderness, bloating, moodiness, and headaches.
Low progesterone: Progesterone stabilises the uterine lining and balances oestrogen. If too low, the lining may shed early, leading to spotting or painful bleeds.
2. Endometriosis or Adenomyosis
Extra tissue growth inside or outside the uterus can cause long bleeds, mid-cycle bleeding, pain during sex, and inflammation. These conditions may also affect how your body responds to progesterone.
3. Fibroids or Polyps
These benign growths, often linked with high oestrogen, can disrupt normal bleeding patterns.
4. Tissue Changes in the Cervix or Uterus
Thin or fragile tissue can bleed more easily, especially after sex.
5. Stress & Nervous System Load
High cortisol affects ovulation and progesterone production, leading to spotting. Chronic stress can also slow thyroid function, further disrupting cycles.
6. Gut Health & Inflammation
The gut microbiome plays a role in oestrogen metabolism and endometriosis progression. Imbalances here can worsen bleeding patterns.
When Should You Take Spotting Seriously?
Always. Spotting or bleeding outside your period is a sign worth investigating. You don’t need to “just put up with it.”
How I Support Women With Spotting & Irregular Bleeding
When a woman comes to see me for bleeding outside her period, I start with:
Comprehensive Case Taking
Looking at symptoms, cycle history, and patterns (e.g. insomnia before a period may point to low progesterone).
Testing
Day 2–3 hormone panel: FSH, LH, oestradiol, free testosterone, prolactin
7 days post-ovulation panel: oestradiol + progesterone
General bloods: iron, B12, inflammatory markers
Specialist women’s ultrasound
Stool testing (to investigate gut drivers of endometriosis or inflammation)
Targeted Treatment
Herbal medicine → reduce bleeding, support hormones, calm inflammation
Nutrition + supplementation → correct deficiencies, support thyroid and gut
Lifestyle & stress support → nervous system care to reduce cortisol impact
Diet adjustments → anti-inflammatory, hormone-friendly meal planning
Client Story
One client had been spotting for over 2 years, alongside pelvic pain. Despite multiple GP visits, no one had checked her hormones. Through stool testing, hormone assessment, and targeted support with herbs, diet, and stress care, her cycles are now more stable, and she finally has clarity on what’s going on.
Conclusion
Spotting isn’t “just hormones” or something to brush off. With the right assessment and personalised support, you can find the root cause and start feeling in control again.
👉 If you’re experiencing bleeding between periods, book a 1:1 consultation today. Together we’ll uncover what’s really going on and get you on the path to balanced cycles and better health.