When It’s Normal and When to See a Doctor

• Ovulation bleeding is vaginal spotting that occurs around the time you ovulate.
• It lasts about a day or two, tends to be watery and costs less than one tablespoon.
• You may also experience other symptoms such as increased libido or cramps.

Menstrual bleeding, or spotting, can be due to a number of reasons, one of which is called ovulation bleeding.

If you are mocking, it is important to be aware of any other symptoms you are experiencing that may indicate that mid-cycle bleeding is caused by something more serious.

What is ovulation bleeding?

Ovulation bleeding is very mild bleeding or spotting that occurs before, after, or during the time of ovulation, says Jane L. Frederick, MD, FACOG, an OB-GYN and reproductive endocrinologist at HRC Fertility, a subsidiary of Keck Medicine of USC.

Ovulation is the point in your menstrual cycle when one of your ovaries releases an adult ovum.

It typically occurs in the middle of your cycle, which would be day 14 in a 28-day cycle, or about a week after the last day of your last menstrual period.

Why can you bleed during ovulation

Hormonal changes are to blame for ovulation bleeding. Right before ovulation, estrogen levels peak, and immediately after ovulation, estrogen levels drop.

“Because of the drop in estrogen, your uterine lining starts to lose just a little bit,” says Frederick.

Frederick says that ovulation should bleed:

• Hold for a day or two
• Be light pink or dark brown
• Has a watery consistency
• Amount to less than one tablespoon of blood in total

Frederick says you may experience other symptoms during ovulation such as:

• Increased secretion, which will be thin, clear and stretchable
• Increased libido
• Chest tenderness
• Unilateral abdominal pain, known as moderate pain

When should you see a doctor?

“Bleeding that is heavy in the middle of the cycle is not normal. If bleeding is recurrent, it should be evaluated by your gynecological provider,” says Scott Dinesen, DO, FACOG, an OB-GYN at Axia Women’s Health.

In addition, if you experience any worrying symptoms such as heavy bleeding, pain, or unusual discharge along with the spotting, you should talk to your doctor, as you may experience one of the following underlying conditions:

• Uterine fibroids: If you have fibroids (benign growths in the uterus that vary in size), the bleeding will typically be heavier, and you may also experience pain and pelvic pressure, Dinesen says. There are many treatments for fibroids, including hormone-targeted medications, minimally invasive procedures, and surgery.
• Uterine or cervical polyps: If you have polyps, Dinesen says you’ll probably experience sporadic bleeding throughout the month, not just in the middle of the cycle. Your periods can also be very heavy. Your doctor can remove polyps with simple procedures in the office, such as turning the polyps off when they are small, or using electrocautery for larger polyps.
• Hyperthyroidism: Since your thyroid gland helps regulate your menstrual cycle, Frederick says thyroid diseases such as hyperthyroidism or hypothyroidism can cause irregular periods. If you have hyperthyroidism, it means that you have an overactive thyroid gland, which is usually accompanied by other symptoms including anxiety, difficulty sleeping, weight loss and muscle weakness. Treatment ranges from antithyroid drugs to surgery.
• Hypothyroidism: On the other hand, hypothyroidism – when you have an underactive thyroid gland – can cause spotting, fatigue, weight gain and heavy periods. If you have hypothyroidism, treatment is thyroid replacement medication.
• Polycystic Ovarian Syndrome (PCOS): People with PCOS have a hormone imbalance that can prevent ovulation, which can lead to irregular bleeding, Frederick says. You may also experience symptoms such as excessive body hair, facial hair, acne and difficulty getting pregnant. “PCOS onset can be diagnosed when menstruation begins at age 12, and is irregular in duration. Often it is not diagnosed until a woman has infertility symptoms and is evaluated by her specialist,” says Frederick. Treatment options include birth control, weight loss and anti-androgen medications.
• Sexually transmitted infections (STIs): Frederick says STIs such as chlamydia and gonorrhea can cause bleeding between periods. These STIs can also cause symptoms such as painful urination and abnormal vaginal discharge. STIs such as chlamydia and gonorrhea are typically treated with antibiotics.
• Cervical cancers: While cervical cancer is rare in younger women, Dinesen says it can be a cause of irregular bleeding. The average age for a cervical cancer diagnosis is 50, and 20% of cervical cancer cases are in women older than 65. You may also experience an overall increase in discharge, and bleeding after sex. Treatment options are surgery, radiotherapy and chemotherapy.

Insider takeaways

Ovulation bleeding refers to very light bleeding or spotting that can occur in the middle of your cycle due to hormonal changes. If you experience other worrying symptoms along with your mid-cycle bleeding, make sure you see your OB-GYN to determine the cause.