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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 frequently asked fertility questions. 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 your gynecologist.

Causes Of Mid-Cycle Spotting

Abnormalities of the Cervix

Though rare, conditions of the cervix such as HPV, polyps, 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. The primary problem with endometriosis is heavy, painful periods.

Uterine Health Issues

Uterine polyps, fibroids and adhesions may all be suspect in cases of mid-cycle spotting. For polyps and fibroids, there is a hormonal imbalance component (discussed more below) and extra tissue known to be responsive to fluctuating estrogen. Inflammation is also a culprit, a natural cause of adhesions (scar tissue) formation.

One 2006 prospective cohort study presented at the 60th American Society for Reproductive Medicine annual meeting shared of 1009 women being evaluated by saline infusion sonohysterography (SIS) for uterine abnormalities and malformations as cause of their infertility, or who had abnormal uterine bleeding.

  • 16.2% of the women in the infertility group were found to have uterine health issues; polyps, submucosal fibroids or adhesions, compared to 39.6% in the abnormal uterine bleeding group.
  • 20% of women in the infertility group compared to 9.5% in the abnormal uterine bleeding group, had “uterine anomalies”, on of which being an arcuate of curved uterus near the fungus (top).

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 disrupts 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 and if it does, it could be a sign of early pregnancy loss. However, bleeding in early pregnancy can lead to a completely normal birth and healthy baby.

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, luteal phase defect (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, 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 reassuring 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 lack of appropriate ovarian production of progesterone. 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 or too low 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. 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, and anovulation. 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:

  • Hormonal Contraceptive Use
  • Intrauterine Device (IUD)
  • Ectropium from birth control pills
  • Luteal Phase Defect (LPD)
  • Excessive exercise
  • Cervicitis
  • poor nutrition

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. Discuss with him/her the effectiveness of saline infusion sonohysterography (SIS). Researchers concluded in the study noted above and published in the journal Fertility and Sterility that, “SIS should be considered routinely in the early stage of infertility and abnormal uterine bleeding investigation.”

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.


Dr. Kimberly Langdon Cull M.D., OB/GYN
Dr. Kimberly Langdon Cull M.D., OB/GYN

Dr. Kimberly Langdon Cull is a University-trained Obstetrician/Gynecologist with 19-years of clinical experience. She delivered over 2000 babies and specializes in gynecologic diseases such as menstrual disorders, infertility diagnosis and treatment especially pertaining to tubal blockage and polycystic ovarian syndrome (PCOS). Dr. Langdon is the inventor of 6 patent pending medical devices, and attended Ohio State University from 1987-1995 receiving her Medical Doctorate Degree (M.D.) with Honors in Obstetrics and Gynecology.

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  1. Avatar

    Hi there,

    I am 20 years old and have recently started getting my period again after ten months without. Unfortunately my cycle has come back very irregularly. However, it has been two months now and have had my period as of today for the fifth time – a week on , a week off. It is getting very annoying, not to mention tiring!

    A month ago I switched from Noriday to Cerazette.

    Many thanks, Charlotte

    • Dear Charlotte,

      I know it seems a challenge to have an irregular, but depending on the cause of the absent period, it may take longer than two months for it to return to a regular pattern. It returned, that is a start! Are you still on birth control? What was determined to be the cause of menstruation stopping. May I know more about you… your diet/lifestyle, etc.? If it would be better to share this in private, do contact me here…

  2. Avatar

    I Track my ovulation with an ovulation kit and I was confirmed ovulating day 1, that evening I had a bit a dark brown/light pink blood not much just spotting which is new to me the first time. I was a bit alarmed, the next day a little bit of spotting checked with my ovulation kit and I wasn’t ovulation? spotted a bit for 1 more day and my abdominal area is tender no more spotting. I am consistent with my cycle every 27-28 days. what could this be and y did I only ovulate for 1 day?

  3. Avatar

    I am 39 years old and today will be exactly 2 weeks after my period. My husband I and have been trying to conceive in the last few days and this morning I saw bright red blood coming out from my vagina. What could this be? My cycle is 27-28 days.

    • Dear DT,

      I am not certain, but it could be that ovulation happened (particularly if the bleeding stopped). It could be from intercourse if you were even the slightest bit dry. It seems to be more the hormone shift causing ovulation. If bleeding is heavy or accompanied by other symptoms, do check in with your doctor.

  4. Avatar

    Hi I’ve been experiencing light spotting in between my cycles for last year and a half now.I’m 22.Last October2017, I was taking collagen to make my hair longer faster.I noticed everytime I took it, I spotted.the spotting varies between light pink, brown to dark red blotches for 2-4 days.its not heavy!just enough tho that i have to wear a panty liner.I stopped taking the collagen back in may and the spotting stopped for two months straight!Now this month, August, I experienced spotting again.I have been stressed lately more than normal.Could it be stress?Could it access collagen built up in my system?Is my body more sensitive to such things?I’m about 108lb.Little worried please help thank u!

    • Dear Purity,

      I have not ever heard of a link between collagen and spotting between periods, nor has this been my personal experience. I’m sorry you are worried!

      Can you clarify, did the spotting start prior to October of 2017 and starting the collagen? To be honest, it seems something else is likely the cause. Stress can be one cause.

      I think it will be helpful to document in each cycle when exactly the spotting is happened.
      (so you will need to get to know your follicular and luteal phases and when ovulation occurs). Keep track of days of high stress as well. Hopefully you will begin to see a pattern and then this will perhaps helps you know the cause.

      In any event, work to find tools to help you through the stress. If you’d like, reach back out to us when you begin to see a pattern in the spotting… and consider also learning more from our Natural Guide for Menstrual Health.

  5. Avatar

    I was taking Omifin, and stopped, this is my first cycle after it and I had some bleeding on day 12 is that ovulation bleeding or lack of ovulation? It is somehow heavy not spotting only?

    • Dear Ana,

      I can not be certain what this is. It could be from stopping Omifin, or ovulation/anovulation perhaps. It can take the body a bit of time to re-balance after using Clomid. I feel like a very helpful resource for you will be our Video: Clomid – What You Should Know And Natural Alternatives.

      I may be able to guide you further if I learned why you used Omifin and for how long, as well as what fertility health issues you are faced with. So reach back out if you would like continued support.

  6. Avatar

    My husband and I had sex one week after my period started and I am now on day 13 and experience some spotting. I have never experienced spotting during mid cycle and I usually have 28-30 day cycle. Do you have any suggestions on what this could be?

  7. Avatar

    I experienced spotting for the first time of my life yesterday and i am really frightened ( i am 25) I had my last period on 31 May 2018 and i had a Vaginal Smear about a month ago and there was no abnormalities. the spots are dark red with a little bit of menstrual pain. I go to the Gym 5 days a week and i am on a caloric deficit and i have also been taking a supplement ( about one month and a half) that contains Soy Isoflavones and Extract of Chasteberry could this be the cause of my bleeding ? Thank you so much.

    • Hello Yulia!

      It seems the new extract could be at play or perhaps this is ovulation spotting. Some women to experience cycle shifts when they first begin taking Vitex. It seems you may be near mid-cycle and ovulation. Please don’t be frightened, simply pay attention to your body.

      One last thing is that we often don’t suggest the use of soy isoflavones. We share why at this link: in question #6.

  8. Avatar

    i have a 25 day cycle. My period lasts for three days. in my current cycle my period ended on the 3rd of June. Today is the 11 th of June and i have experienced bleeding from my Vagina. What could be the cause

  9. Avatar

    For the first time I noticed light pink blood stain which lasted for 3days when I wipe my vigina, and it started day 16 of my period, please what could be the cause?
    NOTE: The previous period came on 47day(initially thought I was pregnant) and lasted for 7 days and it was heavy which is unusual. I initially took Clomid drug for 5days.

    • Dear Beau,

      This could have been ovulation spotting.

      I wonder if the extended previous cycle length and period were a result of the Clomid?

  10. Avatar

    I recently had bleeding mid-cycle, I am on Letrozole 5mg. I did not ovulate per my progestrone leveles. My bleeding was for 2 days – light, 1 day – spotting. Would you consider this a period?

    • Dear Becky,

      No. We’d consider this mid-cycle spotting.

    • Avatar

      Sorry I was confused from the sentence above “When ovulation fails, no corpus luteum is formed and progesterone is not secreted. As a result, a lighter or shorter period may be experienced.” As it states it is a shorter period.

      So because I did not ovulate, I will not get another period… unless induced (as in the past). Correct?

    • Dear Becky,

      Not necessarily. Just because one does not ovulate does not mean menstruation won’t happen. There are women who menstruate without ovulating. If you have had to induce periods in the past, then perhaps this cycle will be the same.

    • Avatar

      If I would like to conceive naturally… what is the best way to begin this after I have been on Letrozole?

    • Hi again Becky!

      I don’t feel I know enough about you to share more than what we have in our guides Getting Ovulation Back on Track and 5 Simple Ways to Promote Regular Ovulation, but perhaps they will provide just the tips you need.

      If not, consider participating in our Fertility Consultations program thru which you can share in a private way all details about yourself and your fertility health with a certified fertility herbalist in order to receive a personalized natural fertility program. Learn more about and/or book a Fertility Consultation here…

  11. Avatar

    Hi, i didnt take any medication or even stress, i had regular period till date. only in march i got 2 periods in 5 days gap and after still i am getting spotting (brown blood) . I dont know exact reason and I dont have any health issue till date. But i having tried, body heat, frequent uranation and head ache. I have checked twice HPT it comes negative. please advice me what i need to do. I am 31 yrs old and trying for baby for last 6 months. whether this will affect my pregancy. please advice

    • Hello Vissa!

      Could it be that you have an illness, a virus or influenza? If the symptoms you experience do not go away within 2-3 weeks or so, it would perhaps be best to check in with your doctor.

  12. Avatar

    Hi, I got period on 7th mar and again 16th mar within 10 days. Still i am geting spotting in brown, whether i am pregnant, i have took home test, it shows negative. I dont know the exact reason for 2nd time period within 10 days. I am getting regular periods.
    Please help what i need to do.

    • Dear Vissa,

      It can take some detective work to figure out what is causing irregular cycles. Have you recently changed your diet or lifestyle, become more sedentary or changed exercise routines? Have you been under undue stress? Have you started of stopped prescription medication or fertility herbs? Do you have any known health or fertility health issues?

      Think back to these two irregular cycles and try to pinpoint anything in your control that could be contributing. This may help with moving forward on a natural fertility program.

  13. Avatar

    i have saw my period on 10th of March and now it came out yesterday been 26th of march, the color is bright red color. pleas i need your advice, am TTC, please i need help.

    Thank you. Hope to read from you.

    • Hello!

      I am sorry this is worrisome! I am also sorry that I don’t really know enough to guide you well. Has this happened to you before, or was it just this one time? Has the bleeding continued today? Are your periods irregular or typically regular?

      If this has only happened once and bleeding is stopped, and nothing else is seemingly off, then this may not be cause for concern.

  14. Avatar

    Hi. I just started using prenatal vitamins last month and started working out more and changing my diet. We are TTC. This month midcycle and had light brown-dark brown spotting that turned into sticky dark discharge over the course of 2-3 days. It stopped for 2 days then I got light pink spotting which turned to bright red spotting over the course of 3-4 days. The bright red spotting is light and watery but is enough to wear a pantyliner. Overall the brown/pink/red spotting has lasted over a week. Is this any concern? I also have slight pain on my right side. Should I go to the doctor?

    • Dear Jessica,

      I can’t know… If you feel like you need to at least call the doctor’s nurse, do. It could be a result of ovulation, or perhaps an ovarian cyst rupture (although the pain is often more than slight). It seems a bit early for implantation spotting, but perhaps it is that if you are later in the two week wait.

      It may be nothing to worry about and I hope a quick chat with your doctor or his/her nurse will be reassuring.

  15. Avatar

    I had a D&C February 6 and took a pregnancy test after to monitor hormones and it came back negative. My period came 4 weeks later on March 6th and lasted its normal 4-5 days. Today, day 9, I experienced some spotting when it wiped and I have been having some right uterine pain. It’s not like me to spot and I don’t know what is going on.

    • Dear Nakia,

      I am sorry for what you are going through!

      This may just be the uterus healing, could perhaps be ovulation even, and perhaps is nothing to worry about.

      Try a warm or cold pack on the abdomen, gentle massage if the pain is not too bad, a warm bath or a walk. Stay hydrated too and see what happens. If the bleeding becomes heavy or lasts longer than today, or the pain gets worse to the point where it disrupts your life or causes you to not feel well, do reach out to your healthcare provider to talk through what you are experiencing.

  16. Avatar

    Hello Elizabeth,

    I am experiencing some spotting (light brown/pinkish color).. I am due to get my period in 9 days. I am on Tri-lo-marzia birth control which I was switched to 4 months ago. Before that I had been taking tri-sprintec for years. My husband and I had sex 2 weeks ago 2/17 (which was day 7 of my placebo week). I have not missed any pills though I may take them a few hours later than normal some days. What could be causing this spotting? I have never had irregular bleeding before.. Your comments are greatly appreciated!

    • Hello Hillary!

      I truly can not know. It does not seem it could be a result of ovulation, as you have consistently been on birth control. It could be due to stress, travel, a hormonal shift, irritation from intercourse, or perhaps leftover blood from menstruation, or maybe even implantation spotting, etc. If this has never happened before, perhaps it is not cause for concern.