Nearly half (43%) of women feel menstrual health education at school didn’t prepare them to understand their periods, according to the results of a new survey conducted by Bodyform and Censuswide. And it’s a knowledge gap that can have far-reaching consequences for women’s health – particularly if people are unaware of potentially abnormal bleeding symptoms.
Here, Tania Adib, a consultant gynaecologist and menopause specialist at The Lister Hospital, breaks down the signs your bleeding might not be normal – and when to seek medical advice.
‘Vaginal bleeding can be worrying, but it's important not to ignore it,’ she highlights. ‘While many causes are easily treated, some symptoms require prompt medical assessment.’
Abnormal bleeding, adds Adib, can be caused by a number of things, such as:
- ‘Benign polyps on the cervix or inside the womb.’
- ‘Infection – including bacterial vaginosis or sexually transmitted infections.’
- ‘Cervical ectropion [a red-looking area on the outer surface of the cervix], commonly linked to the contraceptive pill.’
- ‘Vaginal dryness – particularly during peri- or post-menopause.’
- ‘Hormonal imbalance or HRT adjustment.’
- ‘More serious conditions, including cervical or uterine cancer.’
The key is always to get something checked as soon as possible, says Adib, who adds that all of the above can be ‘effectively treated when they are investigated early’.
5 bleeding symptoms you should never ignore
She encourages arranging a medical appointment if you experience any of the following symptoms:
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- ‘Bleeding after sex’
- ‘Bleeding between periods’
- ‘Any post-menopausal bleeding’
- ‘Blood-stained or unusual discharge’
- ‘Pelvic pain alongside bleeding’
‘Any change in your cycle that feels unusual or concerning, please do get checked,’ Adib reiterates.
It might be that upon further investigation, the issue is benign – but because these symptoms could point to something more serious, it’s always worth getting checked out.
Below, Adib breaks down these bleeding red flags further.
Bleeding after sex
‘Occasional light spotting may occur due to vaginal dryness, particularly after a period without sexual activity. However, persistent or recurrent bleeding after sex should always be assessed.’
Bleeding between periods
‘Bleeding outside your normal cycle is not usually considered normal. If it happens more than once or becomes a pattern, do go speak to your doctor as this isn’t normal and can be down to a variety of reasons.’
Post-menopausal bleeding
‘Any bleeding occurring more than 12 months after your last period should always be investigated – even if it happens only once.
‘Women starting HRT may experience some irregular bleeding while hormones settle. However, established HRT users, or women not taking HRT, should seek an assessment for any post-menopausal bleeding.’
Even if something more sinister isn’t at play, if something is causing you any discomfort or distress, you should always be able to explore potential treatment options and feel supported.
‘Women often worry about making a fuss or wasting time, but early assessment can provide reassurance and, where necessary, allow treatment to begin quickly,’ says Adib. ‘Trust your instincts and seek advice if something does not feel right.’
Hannah Bradfield is a Senior Health and Fitness Writer for Women’s Health UK. An NCTJ-accredited journalist, Hannah graduated from Loughborough University with a BA in English and Sport Science and an MA in Media and Cultural Analysis. She has been covering sports, health and fitness for the last five years and has created content for outlets including BBC Sport, BBC Sounds, Runner’s World and Stylist. She especially enjoys interviewing those working within the community to improve access to sport, exercise and wellness. Hannah is a 2024 John Schofield Trust Fellow and was also named a 2022 Rising Star in Journalism by The Printing Charity. A keen runner, Hannah was firmly a sprinter growing up (also dabbling in long jump) but has since transitioned to longer-distance running. While 10K is her favoured race distance, she loves running or volunteering at parkrun every Saturday, followed, of course, by pastries. She’s always looking for fun new runs and races to do and brunch spots to try.
