Mid-Cycle Spotting

Written By: Dr. Nathalie Burnier, ND

In this post, we will talk about mid-cycle spotting. I’ll go through what mid-cycle spotting is, possible causes and reasons, as well as next steps in terms of investigating those possible causes. 

It can be overwhelming and a bit scary to turn to Dr. Google for an answer about your mid-cycle spotting – since Dr. Google is notorious for overreacting and overdiagnosing very serious conditions. 

That’s why I’ll go through possible causes and outline which ones are more concerning than others. 

Most of the time, mid-cycle spotting isn’t a cause for concern unless we’re seeing irregular bleeding and inconsistent spotting, because that can be a sign of other underlying health issues. 

✴️First you’ll want to make sure to differentiate between spotting and your period. 

✴️This will help give you some clues as to possible causes as well. 

✴️You’ll want to also have some lab tests and other investigations done to narrow down the possibilities. 

What is mid-cycle spotting

Spotting is light vaginal bleeding that occurs outside of your period; you shouldn’t need a pad, tampon, or cup – this would be considered bleeding vs. spotting

How it’s different from your period

🔴 Colour – period will be bright to dark red 

Mid-cycle spotting will likely be light pink or red or dark brown, small amount, and last for a short time 

(a few hours to a day or two)

🔴Volume – period will be heavier, and last a few days 

Possible Causes and Reasons

Implantation Bleeding

This occurs when a fertilized egg attaches to your uterine lining. Up to a third of women experience implantation bleeding as an early pregnancy sign. It doesn’t pose any danger to the developing embryo and usually occurs a few days before your next scheduled period. This blood will most likely be light pink or dark brown. If you have any other early pregnancy symptoms, it might be worth taking a pregnancy test.

Ovulation Spotting

Around 5% of women have mid-cycle spotting during ovulation. There isn’t any cause for concern with this either. Blood will usually be pink or light red, and the bleeding should be light and last only a day or two. With your tracking app, make sure to make a note of the bleeding and see if it lines up with your ovulation days.

Sexual Intercourse

During ovulation, your cervix becomes more sensitive and is actually located lower. Sex at this time can irritate the cervix and produce light bleeding as a result. Vaginal dryness is another cause of post-sex bleeding. This could result in bright red blood-tinged mucus after having sex.

Sexually-Transmitted Infection

This is a less common cause, but STIs can also cause bleeding after intercourse. Untreated STIs can lead to pelvic inflammatory disease (PID) and cause mid-cycle spotting.

Birth Control Methods

Some types of birth control can cause mid-cycle bleeding. If you recently started a hormonal contraceptive (within the past few months), talk to your healthcare provider to make sure you’re on the most appropriate dose. If you’ve recently inserted an IUD and experience spotting, you may want to ask your doctor to check its placement.

Lifestyle Causes

Excessive exercise, having a poor diet that lacks necessary nutrients, and stress may all contribute to mid-cycle spotting. This is why we include diet and lifestyle information in the FCM program to ensure our members are eating healthy diets, getting enough nutrients that they need, and exercising in a way that works for their bodies.

Hormonal Imbalances and Conditions

Hormonal Imbalances and Conditions: An imbalance in your HPO axis (or hypothalamic-pituitary-ovarian axis) can trigger mid-cycle spotting. Certain conditions are also associated with mid-cycle spotting, including endometriosis, PCOS, thyroid disorders, luteal phase defects, ovarian cysts, uterine fibroids, and cervical issues.

Ovarian Cyst Rupture

If you experience a sharp pain on either side of your lower abdomen followed by slight bleeding around the time of ovulation, you may have a ruptured cyst. If you experience excruciating pain, nausea, vomiting, or vaginal bleeding during any point in your cycle, make sure you see your doctor or go to the emergency room right away.

How to investigate what is going on if you’re experiencing mid-cycle spotting?

The first step in figuring out what’s causing your mid-cycle spotting is to track when and how it occurs. This will give you some idea of possible causes. Here are some things to consider:

✴️Tracking – see if the spotting is occurring around ovulation, if it generally occurs after having sexual intercourse, or if your cycles are irregular.

✴️Track when the spotting occurs (i.e., which cycle day), how long it lasts, the color and consistency, the amount of blood, and other related symptoms.

Lab tests

To help you narrow down the possible causes of your mid-cycle spotting, you may need to have some lab tests done. Here are some common tests that your doctor may recommend:

  1. Pregnancy test – to rule in/out pregnancy.
  1. STI test – to rule out sexually transmitted infections.
  1. Thyroid panel.
  1. Day 3 hormones – FSH, LH, estradiol.
  1. 7DPO Progesterone.
  1. PAP test – to test for STIs and abnormal cervical cells (precancerous or cancerous cells).

Pelvic Ultrasound

A pelvic ultrasound can help your doctor see if there are any ovarian cysts, fibroids, polyps, or signs of endometriosis.

When to See Your Doctor

As long as the bleeding is not excessively heavy, severe, or prolonged, it’s usually not a problem. But always discuss mid-cycle spotting with your doctor or fertility specialist so they can check that there aren’t any serious underlying issues.

In conclusion, mid-cycle spotting can be unsettling, but it’s usually not a cause for concern. By tracking your symptoms and undergoing some lab tests, you can determine what might be causing it and take steps to address it. Remember to always consult your doctor if you have any concerns. Leave a comment below if you found this article helpful, and tag us if you have any questions.

If you feel you need support in figuring out what’s going on with your mid-cycle spotting or more information about balancing your hormones, feel free to book a FREE discovery call with me HERE and we start creating a strategic plan that will help you.