Seeing blood spots in your underwear when your period ended days ago can feel puzzling and concerning. Known as intermenstrual bleeding, spotting between periods and ovulation is not normally cause for alarm. But in some cases, it can indicate an underlying vaginal infection needs treatment.

The most common culprits of bleeding between cycles are bacterial vaginosis (BV), yeast infections, and sexually transmitted diseases like chlamydia and gonorrhea. Here’s an overview of how these infections lead to spotting:

• Bacterial Vaginosis – Caused by an overgrowth of bad bacteria, BV leads to vaginal inflammation and thinning of the lining. This makes the walls more prone to bleeding. A fishy odor is a hallmark of BV.
• Yeast Infections – Candida fungus irritates the vaginal tissue, causing itchiness and redness. Scratching can disrupt the sensitive lining enough to cause minor bleeding. Yeast infections produce thick, white discharge.
• Chlamydia and Gonorrhea – STDs like these infect the cervix, which can become friable and bleed easily. Pain during sex is also common with chlamydia and gonorrhea.
• Trichomoniasis – This STD invades the vagina, creating an environment prone to spotting and bleeding. A smelly, greenish-yellow discharge occurs with trichomoniasis.

Rising oestrogen levels approaching ovulation create an environment in the vagina that promotes the growth of bad bacteria and yeast. The hormonal changes make women more susceptible to infections during this time of the cycle.

While usually not severe, vaginal infections should always be treated properly. The first step is to test for any infections. My preferred options are at a local sexual health clinic, making sure that also include a test for BV, or I can order the Vaginal Ecologix test for you, and you can gain a comprehensive picture of your vaginal microbiome and identify specific infections.

In most cases, vaginal infection-related bleeding is short-lived once treated. But if you ever experience heavy, persistent bleeding between cycles, seek medical care promptly.

So don’t ignore sporadic spotting. It may be your body’s signalling an underlying infection needing attention. With proper treatment, you can restore healthy vaginal flora, tissue, and pH balance.