Mid-Cycle Spotting – Should You Be Concerned?

Mid-Cycle Spotting – Should You Be Concerned?

mid-cycle spottingPicture this: you wake up one morning and realize you are bleeding. Your last menstrual period just ended a week ago, and you aren’t due to start again until next month. Why are you seeing blood now?

This unexpected bleeding is considered mid-cycle spotting, or abnormal uterine bleeding. When experienced outside of your normal menstrual period, mid-cycle spotting can often be frightening. It brings up a range of emotions and questions you likely don’t know how to answer. Am I pregnant? Do I have a hormone imbalance? What is wrong with my body?

Mid-cycle spotting is one of the most asked about fertility concerns women approach us with. The concern is valid. As far as most of us learned growing up, you are only supposed to bleed during your period, not randomly throughout your cycle. There is some truth to this, but there are also a few exceptions. I hope to help you understand the different causes of mid-cycle spotting, learning to recognize what is normal and when it may be a sign that something isn’t quite right, which may warrant a trip to consult with your gynecologist.

Causes Of Mid-Cycle Spotting

Abnormalities of the Cervix

Though rare, conditions of the cervix such as HPV or cervical fibroids may cause some slight bleeding mid-cycle. If the mid-cycle bleeding is accompanied by pain in the cervical region, it would be best to have your gynecologist check this out. Very rarely, abnormalities of the cervix may be cancerous.


Some, but not all women with endometriosis report mid-cycle spotting. The cause is not completely understood, but it is speculated that a disruption with hormone signaling may be the culprit. Excess endometrial tissue under the influence of hormones may be given disrupted signals, leading to breakthrough bleeding.

Implantation Bleeding

Implantation bleeding can be the most confusing of all, particularly for women currently trying to conceive. The hope is that the spotting they are experiencing is a sign of pregnancy, and not simply another period.

Up to 1/3 of women who conceive will experience implantation bleeding. This occurs at about 6 to 12 days post-conception. The scant discharge, tinted a light pink to brown, is the result of the trophoblast (tissue that forms around the fertilized egg) implanting itself in the uterine lining. The implantation may damage some of the blood vessels in the uterus, which may cause slight bleeding. Because the bleeding can come as late as 12 days post-ovulation, many women mistake this bleeding for menstruation. Implantation bleeding is typically light and lasts anywhere from a one time occurrence, to very light bleeding over the course of two days, at most. It doesn’t become heavier like menstruation bleeding does.

If you think you may be pregnant, take a pregnancy test. You can begin to test for early pregnancy with an at-home early pregnancy test at 7-10 days past ovulation.

Herbs That Have an Action on the Hormone System

When first introducing herbs that have an action on the hormonal system, some women may experience mid-cycle spotting. Many herbs we use to support reproductive health, have an action on the hormonal system, which is why they are so effective at aiding the body in correcting hormonal imbalances. The change to hormone signaling due to the introduction of herbs, may cause temporary mid-cycle spotting. This should only occur for the first couple cycles of use; as the body adjusts to the action of the herbs being taken. Though it may be worrisome, it is best to continue the herb/s. Herbs/herbal formulas are most effective when taken consistently for many months. This gives the body time to adjust to the action of the herb/s and for their benefits to be realized.

Hormone Balance Disruption

There is a delicate orchestra of hormones within each woman’s body that works to keep the menstrual cycle regulated. This is known as the hypothalamic-pituitary-ovarian (HPO) axis. Any type of disruption in this system may trigger mid-cycle spotting.

There are many reproductive health issues associated with HPO axis disruption, including, but not limited to, endometriosis, PCOS, thyroid disorders, LPD, uterine fibroids and ovarian cysts.

If you have never had a hormone profile test performed and you are experiencing recurring mid-cycle spotting, it would be a good idea to schedule a full panel of hormone testing with your doctor. This will help you to know if an imbalance in hormone levels may be the cause of the mid-cycle spotting. If you determine that a hormone imbalance is the cause, you can learn natural ways to support hormonal balance here.

Ovarian Cyst Rupture

If you experience a sharp pain on either side of your lower abdomen, followed by slight bleeding around the time ovulation should occur in your cycle, it may be a ruptured ovarian cyst. Ovarian cysts are a sign of disrupted ovulation, which may cause difficulties in achieving pregnancy.

Note: See a doctor immediately if you have excruciating pain, nausea, vomiting and/or bleeding from the vagina during any point in your cycle.

Ovulation or Failure to Ovulate

This can be a tricky one. Why? Mid-cycle spotting can be a sign that you have ovulated, but it can also be a sign that you didn’t. Charting your basal body temperature (BBT) can help you to know if you are ovulating or not. The rise and consistent increase in BBT is a sure sign you have ovulated and progesterone levels are increasing.

    Some women experience mid-cycle spotting around the time just after ovulation has occurred. This is thought to happen due to the drop in oestrogen mid-cycle, prior to ovulation. Because progesterone levels have yet to rise, a small amount of the endometrium may be shed.

    Failure to Ovulate
    Mid-cycle bleeding in the presence of anovulatory cycles is due to estrogen withdrawal. In women with anovulatory cycles, the follicles begin to grow, though estrogen levels remain low, which means LH doesn’t surge and ovulation fails. When ovulation fails, no corpus luteum is formed and progesterone is not secreted. As a result, a lighter or shorter period may be experienced.

Progesterone Cream Use

    Applying Natural Progesterone Cream at the Wrong Time in the Cycle
    If you use progesterone at the wrong time in your cycle, it may cause spotting to occur and may even cause the timing of your period to change. The best way to make sure you are using the cream at the right time is to calculate your progesterone start date by counting two weeks backwards from when your period is due. This is the most common time in the cycle for women to ovulate.

    Too Much Progesterone Cream
    Applying too high a dose of progesterone cream may cause spotting to occur. This spotting may last only a day or two, or it may occur every day of application, up to menstruation, disrupting the timing of your expected period. The best way to avoid this from happening is to follow the directions on the product label. Better yet, you can consult with a healthcare practitioner who supports the use of progesterone cream in order to have your progesterone levels tested. The progesterone test results will help them to determine an exact dose for your needs.

    The Body is Adjusting to an Increase in Progesterone Levels
    Introducing progesterone may exacerbate estrogen dominant symptoms, such as spotting for a short time, as the body adjusts. When first introducing progesterone back into the body after an extended period of progesterone deficiency, the estrogen receptor sites ‘wake up’ (are stimulated), enhancing the action of estrogen for a short period of time. In this case, the spotting is a sign that the body is responding well to the progesterone, even though at the beginning it can exacerbate estrogen dominance symptoms. Your body should regulate over the following cycle. This is very common in women with PCOS, endometriosis, uterine fibroids and especially low progesterone levels. For a complete guide to progesterone cream use, click here…

Sexual Intercourse

The cervix becomes more sensitive around the time of ovulation, in preparation for pregnancy. Sexual intercourse may cause some slight damage to the cervix, producing light bleeding as a result. The presence of bright red blood tinged mucus after sexual intercourse is a common sign of this.

Other Less Common Causes of Mid-cycle Spotting:

  • Excessive exercise
  • Hormonal Contraceptive Use
  • Intrauterine Device (IUD)
  • Pelvic Inflammatory Disease (PID)
  • Luteal Phase Defect (LPD)
  • Poor nutrition
  • Uterine Fibroids

3 Steps to Resolving Mid-Cycle Spotting

1. Keep track of when it is happening
Determine what day in the cycle this is occurring, how long it lasts, note the color, amount and any other symptoms that coincide.

2. See your doctor
If you suspect a problem within your reproductive system, it is best to get some testing done to determine the cause.

3. Address the Cause
Once you determine the possible cause, talk to your doctor about medical options, while at the same time researching complementary alternative natural therapies to support your body, at home. We have information on natural, complementary and alternative therapies for most all of the causes discussed in this article.

1. Romm, Aviva. Botanical Medicine for Women’s Health. Churchill Livingstone Press, 2010.
2. http://www.wikihow.com/Recognize-Implantation-Bleeding
3. http://www.bellybelly.com.au/conception/ovulation-signs-symptoms-ovulation-days-ovulation-pain#.Usbs5WRDux0

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  1. I’ve been taking vitex for two weeks and then I experienced mid-cycle spotting/bleeding for two weeks now. Should I stop taking vitex since I have a monthly regular period?

    • Dear Ressie,

      Some women spot when they first start supporting hormone balance with herbs. This is often a perfectly normal effect from the hormonal system ‘resetting’ itself. Vitex could be continued. While there may be no need for alarm, if you are concerned, we don’t want you to worry so it would be best to stop Vitex.

  2. Hello I am 21 years old and married. I have irregular periods; and my last one was in the 12th of May 2015. On July I went to the doctor to see if I was pregnant and it came out negative and they also did a transvaginal ultrasound to see if I had any cyst and it came out good… My question is… Is it normal that I spot light pink to light brown when i wipe? This has been happening for 5 days now. I started on Sep. the 1st. Should I go to the doctor?
    The first day I started spotting my back hurt so much that I could’t bend down to pick up things and later that day I noticed I had light pink spotting when I wiped. Today only my lower back hurts and I have mild cramping…

    • Dear Areli,

      If you are concerned, please do reach out to your doctor. He is best able to help you understand what may be happening for you.

      It can be hard, without help, to identify what has led to spotting actually because it can be caused by many different events/factors. It may be caused by:
      Disturbance in hormone balance
      Failure to ovulate, or Ovulation (some women spot when ovulation happens due to the oestrogen changes mid-cycle)
      Abnormalities of the cervix
      Ovarian cysts
      Hormonal contraceptive use
      Excessive exercise
      Poor nutrition

      While some of the events above are not cause for concern, it would be helpful to know if any are contributing factors. So, hopefully you can reach out to your doctor at some point to talk about this. Consider also learning natural therapies for supporting a healthy menstrual cycle here…

  3. Any suggestions for herbs or supplements that can help with spotting? I am 30 years old and experience spotting anywhere from 5-10 days before my actual period which comes every month, lasts about 2 days with a normal period flow and then may spot 3-5 days after. Depending on where I am at with my cycle I also sometimes bleed during intercourse.

    • Dear Amy,

      Spotting can be a tricky fertility health issue to figure out the cause of because many different factors can contribute. This is why this article’s author suggests working with your healthcare provider to determine a cause. Some of the causes may be:
      – Disturbance in hormone balance
      – Failure to ovulate, or that ovulation has occurred – some women experience spotting during ovulation due to the oestrogen changes mid-cycle
      – Ovarian cysts
      – Endometriosis
      – Abnormalities of the cervix
      – Excessive exercise
      – Poor nutrition

      I hope you are able to receive help in determining a cause and when you know, our team may be better able to guide you.

  4. Hi,
    My periods have been regular all my life (24-30 days but most times-27 days with normal mid cycle ovulation), I’ve had one child (3.5 years ago) and I do have a history of endometriosis. Iam almost 33 years old. This month I experienced spotting for 4 days 1 week after my last period ended (I did have unprotected sex the last day of my period and protected sex after that). Now I am on day 33 and still no period. I have also been under stress this month. Did the spotting offset my cycle? Pregnancy maybe but unlikely since I cannot have been ovulating at the end of my period. (I have not taken a test yet). Any advices beside- take a pregnancy test?

    • Dear Anna,

      Rather than spotting offsetting a cycle, the stress may have. Hormone imbalance, poor nutrition, dietary changes, levels of hydration, age, stress and changes in stress levels (even minor changes), weight loss or gain, changes in exercise routines and even travel can all impact menstrual cycle timing. Learn more about Stress and Your Fertility for stress-management tips and more.

      And yes taking a pregnancy test before beginning a natural fertility program is suggested.

  5. HI,
    Thank you for your article, I am 42 this year and I have noticed my cycles are fluctuation between 27 days my norm and 23 days and twice this year I have had spotting light flow for a week in the middle of my cycle.

    This article has eased my mind and I am going to look into some some herbal supplements.
    I am pretty sure I am peri-menopausal as my mum and aunt both went through menopause in the late 40s.
    Hopefully my BF pops the question sooner rather than later and we can try for a baby before the baby factory closes shop.

    If you have any suggestions for herbs that would help support my cycles it would be appreciated.

  6. Since January of this year I have been experiencing mid month light spotting & on some occasions have had a full blown period two weeks after finishing my last one! In Feb & March I had three periods with just a two week break between each?
    Generally the spotting is a pinky brown colour & occasionally this is a period like bleed for couple of days then it stops.
    Typically my cycle was between 33 & 43 days in length but this year that all seems to have changed. I’ve never had any spotting before this year – I’m in my early 30’s & never been on birth control
    I have one child & would like to add to the family but am concerned that I’m perimenipausal or that there is something seriously amiss

  7. I started birth control this month and never stopped bleeding. I’m already on cycle day 12, and I bleed enough to have to wear a pad every day (but not to use it entirely, I change it for sanitary purposes not out of need), but it’s more than just spotting. However, the discharge is completely brown, kinda rusty colored and sometimes it looks a bit flaky, but liquid. Is this normal? It is accompanied by acne and an increase in appetite? The birth control is Dienogest 2mg and Etinilstradiol 0,03 mg

    I forgot to mention, I began birth control to keep at bay a progressive dysmenorrhea, accompanied by a uterine myoma (fibroid), not for birth control.

    • Dear Anna,

      It may be worth reaching out to your healthcare provider or pharmacists to ask this question given I am not qualified to answer question about prescription medications.

      What I can share is that dark, brown blood that looks old is in fact old blood left over from the previous menstrual cycle. This may be caused by a sluggish menstrual flow, lack of uterine tone or low uterine circulation. Excessive bleeding during and length of menstruation are both symptoms of uterine fibroids.

      We can not suggest using herbs that have an action on hormones along with medications that do the same, but it may help to learn more about naturally supporting a healthy uterine environment. Also consider working one on one with our fertility herbalist if interested in a natural fertility program to address the fertility health issues you are dealing with. We offer this through a Fertility Consultation.

  8. Hi. I am breastfeeding an almost 14 month old boy, and have just had my first post partum period. I am now experiencing mild, mid-cycle bleeding. Can breastfeeding cause mid-cycle bleeding and anovulatory cycles?

    • Dear Michelle,

      The hormone changes that occur to produce breastmilk often result in the absence of menstruation, irregular menstrual cycles when they return and irregular ovulation or anovulation. The menstrual cycle may not show regularity until breastfeeding is stopped. This is different for each women.

      If considering preparing for conception while breastfeeding, refer to the article Learn Important Tips for Trying to Conceive While Breastfeeding. If concerned about the mid-cycle bleeding, don’t hesitate to reach out to your healthcare provider.

      All my best!

  9. Thank you for this article. It gave me peace while up late reading about what may be causing my mild mid-cycle bleeding. I will take your advice and keep track of it as you suggested. Thank you.