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Ovulation Bleeding: Spotting Between Periods Explained

Many people associate vaginal bleeding with periods. It’s not uncommon to bleed in between periods, though, for a variety of reasons. While some light spotting may be normal, it may also indicate a health issue or pregnancy.

What is ovulation bleeding?

Ovulation bleeding is light bleeding, or spotting, during ovulation. Ovulation is when a mature egg is released from the ovary. Some people experience spotting during every cycle, others only a few times, and some never do. Ovulation bleeding is characterized by very light bleeding, much lighter than a period, and typically lasts one or two days.

The color of vaginal discharge from ovulation bleeding may range from light pink to bright red or dark brown, depending on the speed of the blood flow. Light pink spotting generally means that blood has mixed with cervical fluid. Ovulation bleeding is generally caused by changes in hormone levels, specifically, a dramatic fall in estrogen that happens right before ovulation and may cause the endometrium — the inner lining of the uterus — to shed.

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Spotting between periods: when is it normal?

Spotting between periods can occur before, during, or after ovulation. In cases of consistent, mid-cycle spotting, using period and ovulation-tracking tools may help you determine when spotting occurs. This may help your health care provider narrow down causes and treatments.

Spotting before ovulation

Spotting before ovulation may be a sign of a reproductive issue.

Irregular spotting one to two weeks apart may indicate that ovulation is not happening at all, especially if there are underlying health causes, such as polycystic ovary syndrome (PCOS), hyperprolactinemia, or thyroid issues, which may affect fertility.

Spotting during ovulation

Spotting during ovulation typically lasts about a day or two. The drop in estrogen that signals the body to ovulate may result in ovulation spotting. Some people who regularly experience spotting during ovulation use this as an indicator to try to conceive (or avoid it). Ovulation may also be accompanied by mild bloating or abdominal cramps, usually on the side that is releasing an egg.

Spotting after ovulation

Spotting after ovulation may indicate “implantation bleeding,” which is when a fertilized egg implants in the uterus. Implantation bleeding can occur 10–14 days after conception — around the time of the first expected day of your period — but there are a couple of noticeable differences.

The color of implantation bleeding is light pink to dark brown, as opposed to the brighter, darker red of menstrual bleeding. Implantation bleeding will also be a lighter flow and last between a few hours and two days. 

Implantation bleeding may cause some side effects, including headaches, nausea, mood swings, light cramping, breast tenderness, low backache, and fatigue, but it doesn’t harm the embryo.

For people who are trying to conceive or had sex without using birth control, a pregnancy test may be a good first step to get to the bottom of any kind of spotting or bleeding outside of a normal period. A pregnancy test detects a hormone called human chorionic gonadotropin (hCG) in urine. HCG can also be detected in blood, but blood tests are done in a clinic. If the test is positive or shows a faint line, mid-cycle spotting or bleeding may also indicate an ectopic pregnancy, missed miscarriage, or threatened miscarriage

Causes of bleeding between periods

Bleeding between periods can occur for many reasons, some normal and others that indicate a health condition that needs attention from a health care provider. Ovarian cysts, pregnancy, and perimenopause commonly cause spotting between periods.

  • Pre-menarche spotting occurs before someone menstruates for the first time. This is generally harmless.
  • Polycystic ovary syndrome (PCOS) is a common endocrine disorder where multiple small unruptured follicles (cysts) grow on the ovaries. Hormonal imbalance and anovulation, or absence of ovulation, can lead to mid-cycle spotting.
  • Ectopic pregnancy is a type of pregnancy in which the fertilized egg implants and grows outside the uterus. An ectopic pregnancy may cause vaginal bleeding between periods. An ectopic pregnancy can be a medical emergency that requires prompt treatment.

Spotting between periods may also indicate an infection. Certain sexually transmitted infections (STIs) can cause spotting between periods, including chlamydia, gonorrhea, and human papillomavirus (HPV). Pelvic inflammatory disease can also cause spotting. If you’re experiencing spotting after having unprotected sex, it’s a good idea to consult with a health care provider. Sexually transmitted infections can lead to serious reproductive complications, including infertility, if left untreated. 

Other possible causes for ovulation spotting include trauma. For example, sexual or blunt force trauma to the pelvis may cause bleeding or spotting. Other common causes include:

  • Forgotten tampon
  • Certain medications, including breast cancer treatments and some hormonal birth control (Spotting is common in the first three months after beginning hormonal birth control as the body adjusts to it.)
  • Foreign object penetration of the vagina or cervix
  • Reproductive cancer or precancerous conditions

It’s important to seek medical attention immediately if you suspect any of these are the cause of your spotting.

How long does ovulation bleeding last?

Most mid-cycle spotting lasts one to two days and occurs between days 11 and 21 of the menstrual cycle — around the time of ovulation. 

Ovulation spotting usually occurs about 14 or 15 days before the next period. Implantation bleeding, on the other hand, will occur just a few days before the next period is expected to begin. Because everyone’s cycles are a little different and the timing of spotting may point to the cause, knowing when a cycle typically begins and ends can help determine why spotting is occurring.

Is it possible to get pregnant while bleeding?

Some non-menstrual bleeding may indicate pregnancy or pregnancy complications. However, if the spotting isn’t implantation bleeding (which can be difficult to determine), it’s still possible to get pregnant if there’s spotting between periods. Because it’s possible for ovulation to occur without a period, it’s also possible for someone to get pregnant before their very first period.

While many specialists believe mid-cycle bleeding is a sign of fertility, it doesn’t necessarily indicate pregnancy. Brown spotting mid-cycle may indicate ovulation, which is when conception is most likely. If spotting between periods comes with pain or cramping, it may indicate an underlying problem. Over-the-counter ovulation testing kits can help determine times when conception is most likely. It’s a good idea to consult with an OB-GYN if you’re experiencing spotting and have certain risk factors such as STIs, if you think you might be pregnant, if you are at an elevated risk for reproductive cancers, or if you are approaching menopause.

The health care provider will ask a few questions about the spotting, and the more information they have, the more precise their diagnosis can be. Treatment options may include lifestyle changes such as weight management, dietary supplements, and hormonal birth control. Medical treatments may be specific to the root cause of the bleeding. Bleeding between periods has many potential causes, some more serious than others, so proper medical diagnosis and treatment is crucial.

Sweet, Mary Gayle, et al. “Evaluation and Management of Abnormal Uterine Bleeding in Premenopausal Women.” American Family Physician, 1 Jan. 2012, www.aafp.org/afp/2012/0101/p35.html.

“CDC - Combined Hormonal Contraceptives - US SPR - Reproductive Health.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 1 Feb. 2017, www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.

Reed, Beverly G. “The Normal Menstrual Cycle and the Control of Ovulation.” Endotext [Internet]., U.S. National Library of Medicine, 5 Aug. 2018, www.ncbi.nlm.nih.gov/books/NBK279054/.

Reed, Beverly G. “The Normal Menstrual Cycle and the Control of Ovulation.” Endotext [Internet]., U.S. National Library of Medicine, 5 Aug. 2018, www.ncbi.nlm.nih.gov/books/NBK279054/.

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