What is ovulation bleeding?
Ovulation bleeding is spotting when a woman ovulates, which is when a mature egg is released from the ovary. Some women experience spotting during every cycle, others only a few times, and some women never do. Ovulation bleeding is characterized by very light bleeding, much lighter than a period.
The blood may range from a light pink to a bright red or dark brown, depending on the speed of the blood flow. Light pink spotting generally indicates that the blood has mixed with cervical fluid. Ovulation bleeding is generally caused by changes in a woman’s hormone levels, specifically, the dramatic fall in estrogen that happens right before ovulation and may cause the endometrium – the inner lining of the uterus — to shed.
Spotting between periods: when can you have it?
Spotting between periods can occur before, during, or after ovulation. If you notice consistent mid-menstrual cycle spotting, track your periods and ovulation cycles to determine when spotting occurs. This may help your doctor narrow down causes and treatments.
Spotting before ovulation
Spotting before ovulation may be your body’s physiological response to the drop in estrogen and increase in progesterone right before an egg is released. This fluid is typically light pink as the cervix may thicken, producing fluid that mixes with the blood.
Harmless pre-ovulation bleeding typically occurs when a mature egg bursts through its follicle and is released. During the menstrual cycle, around 20 follicles, each containing an immature egg, start to grow. One out of the one-to-two-dozen follicles becomes a dominant follicle and produces a mature egg. Right before this mature egg is released from the follicle, estrogen levels drop, which can cause the endometrium to shed and result in light spotting.
Irregular spotting one to two weeks apart may indicate there is no ovulation at all, especially if there are underlying health causes, such as polycystic ovarian syndrome (PCOS), hyperprolactinemia or thyroid issues, that may affect fertility.
Spotting during ovulation
Spotting during ovulation lasts about a day or two. The drop in estrogen that signals a woman’s body to ovulate may result in ovulation spotting. Some women who regularly spot during ovulation use this as an indicator to either become or avoid getting pregnant. Ovulation may also be accompanied by mild bloating or abdominal cramps, usually on the side that is ovulating.
Spotting after ovulation
Spotting after ovulation may indicate “implant bleeding,” which is when a fertilized egg implants in the uterus. Implantation bleeding may occur around the time you expect your cycle to start, 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 12 hours to two days. Unless your cycle is unusually short, menstrual bleeding lasts a few days longer.
Implantation bleeding is harmless to the embryo, although a woman may have some side effects associated with the process. These include headaches, nausea, mood swing, light cramping, breast tenderness, low backache, and fatigue.
Always keep in mind that if you are trying to conceive or for some reason didn’t use any birth control method the first thing you should do if you notice any kind of spotting or bleeding - is a pregnancy test. A pregnancy test detects hCG in your urine or blood. If the test is positive your mid-cycle spotting or bleeding may indicate an ectopic pregnancy or a missed abortion or a threatened miscarriage.
Intermenstrual bleeding causes
Intermenstrual bleeding can occur for many reasons. While some are normal, others indicate a health condition you should discuss with your doctor. Cysts, pregnancy, or perimenopause commonly cause spotting between periods.
- Pre-menarche spotting occurs before a young girl menstruates for the first time. This is generally harmless.
- Polycystic ovarian syndrome (PCOS) is a common fertility disorder where multiple small cysts grow on one or both 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. Ectopic pregnancy may be one of the reasons for intermenstrual vaginal bleeding. Ectopic pregnancies can lead to serious health concerns.
Other times, spotting between periods can indicate an infection, sexually transmitted or otherwise. Certain STDs may cause spotting between periods, including chlamydia, gonorrhea, pelvic inflammatory disease, or HPV. If you know you've had unprotected sex, consult with your primary care doctor if you experience spotting. Sexually transmitted infections can lead to serious reproductive complications, including infertility, if left untreated.
Outside causes for ovulation spotting may include trauma of some sort. 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
- Foreign object penetration of the vagina or cervix
- Reproductive cancer or precancerous conditions
If you suspect any of these are the cause of your spotting, seek medical attention immediately.
How long does ovulation bleeding last?
Most mid-menstrual cycle spotting between periods lasts one to two days and occurs between 11 and 21 days after the first day of your last period — around the time of your ovulation. This range of duration and occurrence means it’s important to track as closely as possible when your cycle begins and ends.
Ovulation spotting usually occurs about 14 or 15 days before your next menstrual period. Implantation bleeding, on the other hand, will occur just a few days before your next period is expected to begin.
Can you get pregnant while bleeding?
Some non-menstrual bleeding may indicate pregnancy or its complications. However, if your spotting isn't implantation bleeding (and it can be difficult to determine), you can still get pregnant if you spot between periods. Young girls who haven't had their first menstrual period, for example, may become pregnant beforehand.
While many doctors believe mid-cycle bleeding is a sign of fertility, it isn't an indicator that you are pregnant. Brown spotting mid-cycle may indicate the best time for you to try to conceive. If spotting is accompanied by pain or cramping, though, it may indicate an underlying cause. If you are trying to become pregnant, you may use over-the-counter ovulation testing kits. However, if you have certain risk factors such as STDs, if you think you may be pregnant or trying to conceive, if you are at an elevated risk for reproductive cancers, or if you are approaching menopause, then you should consult your ob-gyn to determine the cause of your intermenstrual bleeding.
Your physician will ask a few questions about your ovulation spotting, so the more information you can give them, the more precise their diagnosis may be. Certain options for treatment may include lifestyle changes, including weight loss, dietary supplements, or some hormonal birth control or supplements. Other treatments may be specific to the root cause of your bleeding, such as pregnancy care or cancer treatments. Intermenstrual bleeding has many causes, from the benign to the serious, so proper medical diagnosis and treatment is crucial to your health.