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Abnormal vaginal bleeding can be defined as any bleeding outside of a normal menstrual period, postpartum or post-miscarriage bleeding. Mid-cycle bleeding can have many possible causes. Some are benign, while others are extremely dangerous.

Mid-cycle vaginal bleeding always deserves a closer look. In most cases, a speedy trip to your gynecologist is strongly recommended. 

Hormonal contraceptives

If you are using hormonal contraceptives like the birth control pill, Mirena, or NuvaRing, your contraceptive is the most likely culprit of mid-cycle bleeding you experience. Menstrual bleeding is artificially created when you are using these contraceptives, and your body is likely to get it "wrong", especially during the first three months of use. While you can talk to your doctor about about unusual vaginal bleeding, it is very unlikely to be something worrying.

Ovulation bleeding

A significant minority of women in their childbearing years experiences ovulation bleeding. Bleeding around the time you ovulate is caused by hormones more precisely, because your uterine lining has built up in preparation for pregnancy, but your progesterone levels are not high enough to hold it all in yet. Ovulation bleeding is normal, and can be a handy natural sign that you are fertile if you are trying to conceive.

Implantation bleeding

An implantation bleeding is what you will be hoping for if you are trying to get pregnant. This bleeding occurs seven to ten days following conception in some women, right after the embryo implants itself into the lining of your uterus. An implantation bleeding is one of the earliest pregnancy signs around, and as many as one in five women will experience it.

Sexually transmitted diseases

Chlamydia and gonorrhea can both cause mid-cycle bleeding. Both these sexually transmitted diseases can also lead to pelvic inflammatory disease (PID) if left untreated, and PID can create mid-cycle bleeding as well. Pelvic pain is the other tell-tale symptom of these STDs. Any woman who is trying to conceive should ideally be tested for STDs, but women who notice irregular bleeding and pain should always contact their doctor and make sure STD testing is part of the diagnostic process.

Uterine fibroids and polyps

Uterine fibroids are non-cancerous growths that form from the uterus' smooth muscular tissue. Polyps form from endometrial cells. Both can cause discomfort and abnormal vaginal discharge or bleeding. Large fibroids can interfere with pregnancy, while polyps may cause infertility.


Adenomyosis is an overgrowth of the uterine lining, the endometrium. It is similar to endometriosis in that sense, but instead of affecting other organs, adenomyosis affects the muscular wall of the uterus. Women with this condition may suffer from heavy and prolonged periods, pass blood clots during menstruation, and have pain during intercourse.


Cervical, endometrial and ovarian cancer can all cause mid-cycle bleeding. Cervical and endometrial cancer might lead to pain and unusual vaginal discharge, while ovarian cancer is associated with bloating, a feeling of fullness, constipation and frequent urination. Because mid-cycle bleeding can be a cancer symptom in some cases, it is important to get it checked out unless it clearly has an identifiable cause such as the birth control pill, or ovulation or implantation bleeding.

Other causes

Mid-cycle bleeding has so many possible causes that it is hard to describe them all in a blog post. Vaginitis, ectopic pregnancy, celiac disease and a hormonal imbalance can all be responsible depending what your other symptoms are. In some cases, "mid-cycle" vaginal bleeding can even indicate a miscarriage, despite not knowing you were pregnant. Abnormal vaginal bleeding or spotting can even be a side effect of a medication you are taking for a chronic disease. Most women will have a vague idea about the cause of mid-cycle bleeding once they know the possible causes, and if you suddenly start experiencing unusual bleeding or spotting, you don't have to panic right away. Benign causes are likely to be responsible for your symptoms, and you may or may not need medical treatment. If your bleeding does have a serious cause, like cervical or endometrial cancer, or pelvic inflammatory disease, you will however be glad that your symptoms made you see a gynecologist. Early detection is the key to better treatment results, so don't wait and suffer alone.

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