Mid-cycle spotting or abnormal uterine bleeding is bleeding that occurs outside of your menstrual cycle. If you are concerned about mid-cycle spotting, you are not alone.  When fertility is your goal, mid-cycle spotting can be alarming, however it is more common than you think. There are a lot of reason that mid-cycle spotting occurs, so use this guide to understand the symptoms so that you will know when to it is time to consult with your gynecologist or fertility specialist:

  • Hormone Balance Disruption – In each woman’s body, there is a delicate orchestra of hormones that work to keep the menstrual cycle regulated. This is known as the hypothalamic-pituitary-ovarian (HPO) axis. Any disruption to your HPO may trigger mid-cycle spotting. Some of the reproductive health issues associated with HPO axis disruption, are endometriosis, PCOS, thyroid disorders, LPD, uterine fibroids and ovarian cysts. If you are experiencing mid-cycle spotting, you can take a hormone profile test to determine if the imbalance in your hormone levels may be the cause.
  • 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. Ovarian cysts are a sign of disrupted ovulation, which may cause difficulties in achieving pregnancy. If you have excruciating pain, nausea, vomiting and/or bleeding from the vagina during any point in your cycle, see your doctor immediately.
  • Uterine Fibroids – These are benign growths that can form in your uterus, are more likely to cause irregular bleeding if they grow into the uterine lining. Polyps, another type of benign growth, can also grow in the uterus or on the cervix and may cause bleeding. Both fibroids and polyps can be removed surgically.
  • Sexual Intercourse – The cervix becomes more sensitive around the time of ovulation because it is preparing for pregnancy. Sexual intercourse 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. Bleeding after intercourse can also signal a sexually transmitted infection (STI), such as chlamydia or gonorrhea, that should be treated promptly. Another condition that can lead to post-sex bleeding is cervical entropion, in which the fragile glandular cells lining the cervical opening grow on the surface of the uterus. Rarely, post-sex spotting can be a sign of cervical cancer. Your doctor can take a Pap smear, a sample of cells from your cervix — the opening of the uterus at the top of the vagina — to test for STIs and abnormal precancerous or cancerous cells.

Other les common causes of mid-cycle spotting include:

  • Excessive exercise
  • Hormonal Contraceptive Use
  • Intrauterine Device (IUD)
  • Pelvic Inflammatory Disease (PID)
  • Abnormalities of the Cervix (HPV or cervical fibroids)
  • Luteal Phase Defect (LPD)
  • Poor nutrition

If you are experiencing Mid-Cycle Spotting the best thing to do is to keep track of when it is happening.  Note what day in the cycle it occurs, how long it lasts and the color, amount and any other symptoms that coincide. Spotting can mean different things at different stages of your reproductive cycle. Unless your bleeding is excessively heavy or prolonged, it is usually not a problem. It can be hard to tell what’s normal and what’s not and it is always best to check with your physician to make sure that whatever the reason you are experiencing mid-cycle, it will not interfere with you chances to start a family and that it is not a sign of a serious health condition.