Causes, Symptoms, Effect on Fertility

Causes, Symptoms, Effect on Fertility

Ovulation bleeding occurs when you ovulate (when an egg, or ovum, is released from an ovary). Spotting during ovulation can be a normal part of ovulation. It usually happens because of the hormone fluctuations that occur during ovulation.

However, sometimes bleeding in the middle of the menstrual cycle is not normal. This is why it’s important to reach out to a healthcare provider if you see any unusual bleeding during your cycle.

Ovulation usually occurs in the middle of your cycle, around day 14, if you have a 28-day cycle. It can happen earlier or later, depending on your cycle length.

Ovulation is triggered by your hormones, which shift significantly in the days leading up to ovulation and on ovulation day. Estrogen and follicle-stimulating hormone (FSH) spike during the days leading to ovulation. A day or two before ovulation, luteinizing hormone (LH) spikes. Estrogen, FSH, and LH work together to help release an egg from your ovary.

These hormones and the egg’s physical release from your ovary produce several different symptoms. Not all people experience all of these symptoms. Ovulation bleeding may occur only for some people or only during certain menstrual cycles.

Possible ovulation symptoms you may experience include:

  • More cervical fluid, which usually looks clear and feels slippery (like egg whites)
  • A slight drop in basal body temperature, BBT (your body temperature at rest), which will rise after ovulation is over
  • Changes in your cervix (opening to the uterus)—for example, it might move higher into your vagina and feel softer
  • Cramping on one side of your pelvis
  • Light spotting or bleeding
  • Increased sexual desire
  • Breast soreness
  • Increased sensory experience, such as increased smell or taste

Some people experience significant one-sided pain during ovulation. This is often called “Mittelschmerz,” which means “middle pain” or pain in the middle of your cycle. It can be normal for many people, but seek medical care if:

  • The pain is serious and affects your ability to function normally
  • You experience mid-cycle bleeding more significant than light spotting or light bleeding

Many people experience some bleeding around the time an egg is implanted in their uterine lining—if they conceive (get pregnant) during that cycle. This is called implantation bleeding.

Both ovulation bleeding and implantation bleeding are types of light bleeding that can occur when you aren’t having your period. Here are two primary differences:

  • Timing: Ovulation bleeding tends to occur during the middle of your cycle. Implantation bleeding occurs about 1-2 weeks after fertilization. It may be around the time you expect your period or a few days before.
  • Other symptoms: With ovulation bleeding, you will likely have other signs of ovulation, such as increased slippery cervical fluid and an increased sex drive. Implantation bleeding is usually accompanied by PMS-like symptoms or very early pregnancy symptoms such as moodiness and fatigue.

Ovulation bleeding is different from getting your period. Here are some key differences:

  • Timing: Ovulation bleeding occurs midway through your cycle. Menstrual bleeding occurs at the end of your cycle.
  • How long it lasts: Menstrual cycles can last anywhere from 21-45 days. Menstrual bleeding generally lasts 2-7 days. Ovulation bleeding may last only a day or two.
  • Heaviness: Period bleeding can start light, but you will usually have a few days of heavier, continuous bleeding. Ovulation bleeding looks more like spotting

The most common cause of ovulation bleeding is the fluctuation of hormones that happen around the time of ovulation. The spikes in hormones such as estrogen and luteinizing hormone can be sudden and abrupt, prompting light bleeding. This can happen in premenopausal people of all ages.

Unusual bleeding or spotting is more common in adolescents who’ve just gotten their periods, though this is often related to irregular cycles rather than ovulation. People who are nearing menopause may also experience mid-cycle bleeding due to hormonal fluctuations, though this may or may not be related to ovulation.

Other potential causes of spotting or bleeding between menstrual cycles include birth control, irregular cycles, fibroids, and polyps.

Hormonal Birth Control

Mid-cycle bleeding is common among people who take hormonal birth control, especially as their bodies adjust to the medication.

People taking hormonal birth control do not typically ovulate as a result of the pills. However, they may experience “breakthrough bleeding” in the middle of their cycles.

Anovulation or Irregular Cycles

Anovulation is a menstrual cycle without ovulation, meaning an ovary doesn’t release an egg. People who don’t ovulate tend to have irregular cycles, spotting between cycles, and heavy menstrual bleeding.

Individuals with thyroid issues or who have polycystic ovary syndrome (PCOS) may have trouble ovulating and may experience irregular periods or bleeding. PCOS is a hormonal condition that affects the female reproductive organs

Fibroids or Polyps

Fibroids are benign growths found inside the uterus. Polyps are benign growths in the uterus or on the cervix. Both fibroids and polyps can cause spotting and irregular bleeding between periods.

Cancer

While a rare cause of spotting, uterine cancer (cancer of the uterus) can cause irregular spotting. Cervical cancer (cancer of the cervix) can also cause spotting.

Contact your healthcare provider if you experience any new or unusual bleeding. If the bleeding is light and coincides with the timing of ovulation, and you have other signs of ovulation, it’s likely just a normal symptom of ovulation. Still, it’s better to be safe.

According to the American College of Obstetricians and Gynecologists (ACOG), you should contact a provider if you have signs of abnormal bleeding, including:

  • Spotting, light bleeding, or bleeding between periods
  • Spotting or bleeding after sex
  • Unusually heavy bleeding during menstruation

At your appointment, your gynecologist (healthcare provider who primarily treats health concerns related to female sex organs and hormones) will review your medical and family history, pregnancy history, and discuss any medications you are taking, including hormonal birth control. They will ask you to describe your bleeding—e.g., when it occurs, how heavy it is, and other symptoms you experience.

Your healthcare provider may:

  • Perform a pelvic exam to look at the health of your vagina, cervix, and uterus
  • Order blood tests to check for anemia (low iron) or infections, including sexually transmitted infections (STIs)
  • Do an ultrasound of your uterus
  • Take a biopsy of your uterine tissues (less common)

Treatment will depend on the cause. If your bleeding is minimal and related to the hormonal fluctuations of ovulation, it’s likely that no treatment will be needed. If the bleeding is caused by an underlying condition, other treatment modalities will be considered.

For example, people with unusual bleeding between periods are often prescribed hormonal birth control to help balance their hormones. Treating conditions, such as thyroid imbalances or PCOS, can also reduce or relieve symptoms.

Ovulation bleeding doesn’t usually negatively affect fertility. In fact, it is often a sign that you ovulate and are fertile. This is especially likely if you experience some of the other signs of ovulation, like increased slippery cervical mucus, increased sexual desire, and one-sided cramping.

Using an ovulation kit to detect luteinizing hormone is another way of verifying that ovulation is occurring and that you are fertile.

Ovulation bleeding can occur during the time you ovulate and is typically due to rapid changes in hormone levels. You will likely experience other signs of ovulation during this time, like heightened sex drive, more abundant and slippery cervical fluids, increased energy, and one-sided cramping.

Although ovulation bleeding can be normal and a positive sign of fertility, it’s always good to discuss any different or unusual bleeding patterns with a healthcare provider.

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