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Women's Health

Mid-cycle spotting/bleeding



I am 23 y/o. I have been having mid-cycle spotting. It started 5 cycles ago. For three cycles it was a a clear mucus with red blood streaks. It was two or three days in duration, would start on CD21-22 my period would start CD27-29. My last cycle was normal, no spotting. This cycle I had spotting on CD16, actual rust colored bleeding on CD17, and on CD18, 19, and 20 spotting that was either dark brown and watery or a tan/pinkish spotting. I had laproscopic surgery in May of 2007 to look for endometriosis, none was found, even on a microscopic level. My tubes were flushed, and everything else looked "normal" according to my doctor. I have a daughter born 11/2003... no pregnancy or delivery complicatoins excluding a 2nd/3rd degree tear. I have also had salpingitis 4 times over the last year, each time it was a non-STD related bacterial infection. All of my paps have been normal, and I have had at least two a year. I do have a small area on my cervix that feels like a pin-head, but it is only noticable when my cervix is hard and closed. I have been charting my BBT and have not had a temp rise this cycle. I don`t know about previous months. I have also had a lump in my left breast that grows in the same spot every month, it starts a week before my period, and goes away about the third day of menstruation. It is painful and about the size of an almond. I don`t think that I have thyroid problems, but haven`t had a complete physical with blood work for almost two years. I am 126 lbs and 5`5" so I am not over nor underweight. I do not have any outward stress factors, so I don`t think it is stress-related. I am trying to conceive, and came off of Nuvaring in June. I also tried to conceive from 9/2006 to 9/2007, no pregnancy acheived. I do not currently have insurance, but I go to a clinic with a sliding fee, it is still a lot of money to be seen, and each test is an additional fee. Which tests/proceedures do I need? And is this indicative of a problem that requires immediate treatment/diagnosis, or would I be okay to wait to been seen in two or three months when I have employment with health benefits?


Mid cycle spotting can occur because of alterations in the hormonal cycle or structural problems in the uterus. In someone your age, this is rarely a problem that could not wait two or three months for further evaluation.

If the spotting persists, you should have an ultrasound done right before menstruation to evaluate the lining of the uterus or a test called a sonohysterogram.

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Response by:

Lisa M Keder, MD, MPH Lisa M Keder, MD, MPH
Clinical Associate Professor of Obstetrics & Gynecology
College of Medicine
The Ohio State University