10 Causes of Mid-Cycle Spotting

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You look down while using the restroom and notice a spot of light pink or red blood. It's nowhere near the time of your period. In most cases, this mid-cycle spotting is normal. But, if you're concerned about mid-cycle spotting, you're not alone. These are the most common mid-cycle bleeding causes.

What is mid-cycle spotting?

Mid-cycle spotting is bleeding that occurs outside of your menstrual cycle. It's also known as mid-cycle bleeding, abnormal uterine bleeding, intermenstrual bleeding, or metrorrhagia. There are numerous causes, as we'll discuss below.

Not sure if it's mid-cycle spotting or a sign of an irregular period? Look at the color of the blood.

Blood from your menstrual period will typically be bright to dark red. It will be heavier and last for a few days (typically three to seven days for most people). Blood from the more common causes of mid-cycle spotting will be light pink or red, or even dark brown. There will likely only be a small amount. And, it will last for a short time—as short as a few hours.

What causes spotting outside of my period?

When you're trying to get pregnant, mid-cycle spotting can be especially alarming, however, it is more common than you think. There are a lot of reasons that mid-cycle spotting occurs. Some are normal. Others may require an immediate trip to your doctor.

Use the following guide to understand more about mid-cycle spotting symptoms and warning signs. Even if you're not experiencing emergency symptoms, you should discuss any mid-cycle bleeding with your gynecologist or fertility specialist. They can check that there are not any serious underlying issues.

1. Implantation bleeding

If you're trying to get pregnant, one of the more common mid-cycle spotting causes is implantation bleeding or spotting.

Implantation spotting occurs when a fertilized egg attaches to your uterus lining. Up to a third of women experience this symptom of early pregnancy. It's common and doesn't pose a danger to the developing embryo.

This type of light spotting occurs after conception, a few days before your next scheduled period. Instead of the bright red of menstrual blood, this blood will be light pink or even dark brown.

When experienced with other early pregnancy symptoms, it may mean that it's time to take a pregnancy test. Undergoing in vitro fertilization or another fertility treatment? Always get a pregnancy test at your fertility clinic for the most accurate results.

2. Ovulation spotting

Around 5% of women experience mid-cycle spotting right in the middle of their menstrual cycles. It occurs during ovulation, a time when the body undergoes rapid, complex hormonal changes.

For these women, ovulation spotting is generally little cause of concern. Blood is typically pink or light red. Bleeding is light and lasts only a day or two. If you're tracking your ovulation schedule to get pregnant, make a note of this symptom to see if it aligns with your ovulating days.

3. Sexual intercourse

Likewise, your cervix becomes more sensitive around the time of ovulation because it is preparing for pregnancy.

Sexual intercourse at this time may cause some slight damage to the cervix, producing light bleeding as a result. If your cervix is damaged, you will see bright red blood-tinged mucus after sexual intercourse.

4. Sexually-transmitted infections

While not as common, bleeding after intercourse can also signal a sexually-transmitted infection (STI), such as chlamydia or gonorrhea. Untreated STIs can also lead to pelvic inflammatory disease (PID), another cause of mid-cycle spotting.

To ensure this isn't the case, get STI testing from your doctor and treatment, if necessary.

5. Birth control methods

Some types of birth control may cause mid-cycle bleeding.

If you experience spotting after starting hormonal contraceptive use, talk to your doctor to check that you're on the most appropriate dose of medication. If you've recently inserted an intrauterine device (IUD) and are experiencing spotting, you can ask them to check its placement.

6. Lifestyle causes

While not as common, those who exercise excessively or have a very poor diet lacking in necessary nutrients may experience mid-cycle spotting.

There can be complex reasons for these behaviors. Talk to your doctor to get the physical and mental support and referrals you need to heal successfully.

7. Hormonal imbalances and conditions

Your body relies on a delicate orchestra of hormones to keep your menstrual cycle regulated. This is known as the hypothalamic-pituitary-ovarian (HPO) axis. Any disruption to your HPO may trigger mid-cycle spotting.

Reproductive health issues associated with HPO axis disruption include:

If you are experiencing mid-cycle spotting along with irregular periods, talk to your gynecologist or fertility specialist. They'll run tests to determine if the imbalance in your hormone levels may be the cause of your mid-cycle bleeding.

8. Uterine fibroids

Uterine fibroids are generally benign growths that can form in your uterus. They are more likely to cause irregular bleeding if they grow into your uterine lining. Polyps, another type of benign growth, can also grow in the uterus or on your cervix and cause mid-cycle bleeding.

Both fibroids and polyps can be removed surgically if your doctor deems it necessary.

9. Cervical issues

Another condition that can lead to post-sex bleeding is cervical entropion. With this condition, fragile glandular cells lining the cervical opening grow on the surface of the uterus. Cervical fibroids can also lead to mid-cycle bleeding.

Rarely, post-sex spotting can also be a sign of cervical cancer. Your doctor will take a Pap smear—a sample of cells from your cervix—to test for STIs along with abnormal precancerous or cancerous cells.

10. Ovarian cyst rupture

If you experience a sharp pain on either side of your lower abdomen, followed by slight bleeding around the time you should be ovulating, you may have a ruptured ovarian cyst.

If you have excruciating pain, nausea, vomiting, or bleeding from the vagina during any point in your cycle, see your doctor or visit an emergency room immediately.

What to do for mid-cycle spotting

If you are experiencing mid-cycle spotting, the best thing to do is to keep track of it. Many health apps on your smartphone make this easy!

Make note of:

  • What day in your menstrual cycle the spotting occurs
  • How long it lasts
  • The color and consistency
  • Amount of blood
  • Any other related symptoms

Spotting can mean different things at different stages of your menstrual cycle. Unless your bleeding is excessively heavy, severe, or prolonged, it is usually not a problem.

It can be hard to tell what’s normal and what’s not, though, so it's always best to check with your doctor. They can make sure it's not a sign of a serious health condition. If you're trying to get pregnant, they'll check that it won't interfere with your chances of starting a family.

Learn more

At The Fertility Institute, we can help you determine the cause of your mid-cycle bleeding. We welcome patients from across Louisiana and our neighboring states. If there are underlying hormonal causes, health conditions, or structural issues, we can help with fertility treatments.

Call or message us to set up your consultation!

Originally posted on August 9, 2017.