Despite of three-month medication course, I am experiencing mid-cycle spotting and blood clots. What can be done?

Q. What are the causes of mid-cycle spotting and blood clots?

Answered by
Dr. Uzma Arqam
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 16, 2023

Hello doctor,

I am having mid cycle spotting with blood clots. This started a year ago, I had pills to delay my period after that I had my normal period around 15 to 16 th day. I took medication for three months which cleared the issue. Now the issue has reoccured. What could this probably be? Kindly help.



Welcome to

This intermenstrual unscheduled bleeding got relieved after three months course then it could be some hormonal imbalance that was treated after hormone. But now again you have the issue, but there could be other causes as well so better to check those as well. Kindly take the following test:

1. Thyroid irregularities, cervical erosion, cervical polyp or endometrial polyp, pelvic infectious lesion all can be cause of bleeding in endometriosis also there could be post coital bleed.

2. Take thyroid function test, transvaginal scan, take a hysteroscopic examination, high vaginal swab, and cervical smear.

3. Contraceptive pills also can affects menstrual cycle regularity and can give irregular periods .

4. Confirm you are not over due or not having any chance of pregnancy, and there is no relation of this bleeding with conception. You can take a blood serum beta hcG (Human chorionic gonadotropin) test to check your pregnancy status if not sure.

5. If confirmed with no pregnancy then you can have tablet Ponstan (Mefenamic acid) 500 mgs along with tablet Transenexamic acid (Ethylcellulose, Colloidal Silicon Dioxide) 500 mgs every eight hours for two to three days. If it stops with it then it is hormonal imbalance or bleeding due to externally or internally induced hormones.

6. Collect above advised investigations and discuss here or local gynaecologist .

If all laboratory results comes normal then you can have combined oral contraceptive pills as a three months course to support for regulating cycles. Take a healthy diet, daily walk, maintain a normal body mass index and weight. I hope I have cleared all your doubts.

Thank you.

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