Bleeding between periods can be a sign of ovulation or something more serious - here's how to tell

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

Bleeding between periods, aka spotting, can be due to a number of reasons, one being something called ovulation bleeding.

If you are spotting, it's important to be cognizant of any other symptoms you're experiencing that may indicate that mid-cycle bleeding is caused by something more serious.

What is ovulation bleeding?

Ovulation bleeding is very light 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, an affiliate of Keck Medicine of USC.

Related Article Module: When do you ovulate? How to track your cycle and determine when you are most fertile

Ovulation is the point in your menstrual cycle when one of your ovaries releases a mature egg.

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 final day of your last period.

Why you may bleed during ovulation

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

"Because of the drop in estrogen, your uterine lining starts to shed just a little bit," says Frederick.

Frederick says that ovulation bleeding should:

• Last for a day or two
• Be light pink or dark brown
• Have 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 discharge, which will be thin, clear, and stretchy
• Increased libido
• Breast tenderness
• One-sided abdominal pain, known as Mittelschmerz

When should you see a doctor?

"Bleeding that is heavy at the mid-cycle is not normal. If bleeding is repetitive, it should be evaluated by your gynecologic provider," says Scott Dinesen, DO, FACOG, an OB-GYN at Axia Women's Health.

Additionally, if you're experiencing any worrisome symptoms such as heavy bleeding, pain, or unusual discharge along with the spotting, you should speak to your doctor, as you could be experiencing 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-targeting medications, minimally invasive procedures, and surgery.
• Uterine or cervical polyps: If you have polyps, Dinesen says you will likely experience sporadic bleeding throughout the month, not just mid-cycle. Also, your periods may be very heavy. Your doctor can remove polyps with simple in-office procedures such as twisting the polyps off if they are small, or using electrocautery for larger polyps.
• Hyperthyroidism: Since your thyroid helps regulate your menstrual cycle, Frederick says thyroid diseases such as hyperthyroidism or hypothyroidism can cause irregular periods. If you have hyperthyroidism, it means you have an overactive thyroid, which usually comes with other symptoms include anxiety, trouble 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 - can cause spotting, fatigue, weight gain, and heavy periods. If you have hypothyroidism, treatment is thyroid replacement medication.
• Polycystic Ovary Syndrome (PCOS): People with PCOS have a hormone imbalance that may prevent ovulation, which can result in irregular bleeding, says Frederick. You may also experience symptoms like excessive body hair, facial hair, acne, and difficulty becoming pregnant. "PCOS onset can be diagnosed when menses begins at age 12, and are irregular in duration. Oftentimes it is not diagnosed until a woman has infertility symptoms and gets 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 may also cause symptoms such as painful urination and abnormal vaginal discharge. STIs such as chlamydia and gonorrhea are typically treated with antibiotics.
• Cervical cancer: While cervical cancer is rare in younger women, Dinesen says it can be a cause for irregular bleeding. The average age for a cervical cancer diagnosis is 50, and 20% of cervical cancer cases are in women over 65. You may also experience an overall increase in discharge, and bleeding after sex. Treatment options are surgery, radiotherapy and chemotherapy.

Insider's takeaway

Ovulation bleeding refers to very light bleeding or spotting that may occur in the middle of your cycle due to hormonal changes. If you're experiencing other troubling symptoms alongside your mid-cycle bleeding, be sure to see your OB-GYN to determine the cause.

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