"Doctor, I have a few days of vaginal discharge with blood streaks in each intermenstrual period, is there something wrong with me?"
"Doctor, I always have brown discharge in the middle of two menstruations, what's going on?"
Have you ever had a similar problem? Don't be afraid, maybe you just have ovulation bleeding.
Bleeding during ovulation refers to vaginal bleeding that occurs during the ovulation period, which generally occurs on the 13th to 20th day of the menstrual cycle (that is, from the first day of menstruation) [1].
If your menstrual cycle is regular, the time is mostly in the middle of two menstrual periods.
Bleeding during ovulation is common and not a serious disease, so it is not too anxious to appear occasionally.
Symptoms usually include vaginal discharge with blood capillaries, drip bleeding, or brown discharge, which last as few hours, but most last 1 to 3 days, occasionally with discomfort in the lower abdomen, and most resolve spontaneously [1].
According to statistics, 9% of women of healthy childbearing age will have ovulation bleeding, which is a physiological phenomenon that generally does not need to be treated [2].
The cause of bleeding during ovulation is currently unclear. Possible causes are:
Changes in hormone levels, especially declines in estrogen [3,4].
Studies have shown that women with higher levels of estrogen, follicle-stimulating hormone, and luteinizing hormone before ovulation are more likely to bleed during ovulation.
After ovulation, a sudden drop in these hormones (especially estrogen) causes a small amount of endometrial detachment and bleeding.
For most bleeding during the ovulation period that occurs only occasionally, the amount of bleeding is relatively small, and it stops on its own for 1-3 days, and generally does not require medical attention and is good for self-observation [1].
However, if the following conditions occur, it may not be a simple ovulation bleeding, and it is necessary to hang up the obstetrics and gynecology department to see a doctor quickly:
1. Abnormal vaginal bleeding, more or more combined with other discomforts.
"Persistent ovulation bleeding" means bleeding from the ovulation period beyond 4-5 menstrual cycles, or bleeding for more than 7 days at a time;
If bleeding and normal menstrual flow are comparable or even greater, accompanied by abdominal pain, abnormal discharge, etc., it is necessary to see a doctor as soon as this may indicate some other disorder.
Such as: uterine fibroids, endometriosis, endometrial dysfunction, reproductive tract infections, etc. [1,5,6,7].
However, these diseases are mostly accompanied by abdominal pain, menstrual abnormalities (such as large menstrual volume, prolonged menstruation, dysmenorrhea, etc.), and abnormal secretions (such as ectopic, yellowing, etc.).
2. Irregular bleeding
Abnormal bleeding occurs at any time of menstruation, or is unpredictable, and is mostly associated with some non-malignant lesions, such as chronic cervicitis, cervix or endometrial polyps,[2];
Of course, cancer is also possible, such as bleeding after intercourse to rule out cervical cancer [2,8].
3. Other parts of the body are prone to bruising and bleeding.
If you find that you frequently have some bruising, bleeding gums, and large menstrual flow, indicating a possible coagulation disorder (such as platelet or clotting factor abnormalities), you should promptly go to a hematology department to find out the cause [2,9].
If ovulation bleeding does occur, how do we take care of ourselves?
01
First of all, there is enough understanding of ovulation bleeding, Zhimei knows that the first time you encounter this situation, you will inevitably be panicked, so you can first calmly think about whether this bleeding is during the ovulation period;
If so, first eliminate the feelings of tension and anxiety, and pay attention to whether 1-2 days are in line with the characteristics of ovulation bleeding, such as low bleeding and short duration.
02
Pay attention to keep warm, avoid cold irritation, overwork, eat more fruits and vegetables, drink more warm water, and keep the stool unobstructed.
These life-giving cares for themselves can relieve discomfort during bleeding during ovulation.
03
Pay attention to hygiene and avoid infection. Keep your inside dry, it is best to choose a soft cotton and breathable style, change and wash frequently, and dry well.
During bleeding, good hygiene management can effectively avoid genital tract infections.
04
Take a small notebook to record each bleeding in detail.
Including the specific time of bleeding, the amount of bleeding, color, duration, whether there is other discomfort, etc.
It's easy to use the memos that come with your phone or the app that records your period.
Girls must be "well aware" of their own bodies in order to love themselves better. Only by "caring" for your own body can you take good care of yourself and prevent problems before they occur.
After reading today's content, I hope that in the future you can no longer be afraid of ovulation bleeding.
While taking good care of yourself, you should also pay attention to eliminating the "confusion" of other diseases, accurately judge your own situation, and seek medical treatment in time if necessary.
Reviewer
Feng Cuiping | Deputy Chief Physician of the Department of Obstetrics, China-Japan Friendship Hospital
bibliography
[1] Lauren Krouse. What is Ovulation bleeding？Spotting in the middle of your menstrual cycle. https://www.verywellhealth.com/ovulation-bleeding-5182477 Updated: Oct 25,2021.
[2] Malcolm G Munro, Hillary OD Critchley, Ian S Fraser. Abnormal uterine bleeding in reproductive-age patients: FIGO System 1 terminology and symptoms and System 2 PALM-COEIN etiology classification. https://www.uptodate.com/contents/abnormal-uterine-bleeding-in-reproductive-age-patients-figo-system-1-terminology-and-symptoms-and-system-2-palm-coein-etiology-classification UpToDate. Updated: May 27,2021.
[3] Dasharathy SS, Mumford SL, Pollack AZ, Perkins NJ, Mattison DR, Wactawski-Wende J, Schisterman EF. Menstrual bleeding patterns among regularly menstruating women. Am J Epidemiol. 2012 Mar 15;175(6):536-45. doi: 10.1093/aje/kwr356. Epub 2012 Feb 20. PMID: 22350580; PMCID: PMC3299419.
[4] Zawn Villines.Ovulation bleeding:what to know. https://www.medicalnewstoday.com/articles/325847. Jul 24,2019.
[5] Elizabeth A Stewart,Shannon K Laughlin-Tommaso. Uterine fibroids (leiomyomas): Epidemiology, clinical features, diagnosis, and natural history. https://www.uptodate.com/contents/uterine-fibroids-leiomyomas-epidemiology-clinical-features-diagnosis-and-natural-history. UpToDate. Updated:Nov 04,2021.
[6] Robert S Schenken. Endometriosis: Pathogenesis, clinical features, and diagnosis. https://www.uptodate.com/contents/endometriosis-pathogenesis-clinical-features-and-diagnosis UpToDate. Jul 15,2021.
[7] Khalil G Ghanem. Clinical manifestations and diagnosis of Neisseria gonorrhoeae infection in adults and adolescents.
https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-neisseria-gonorrhoeae-infection-in-adults-and-adolescents. UpToDate. Updated:Sep 17,2021.
[8] Michael Frumovitz. Invasive cervical cancer: Epidemiology, risk factors, clinical manifestations, and diagnosis. https://www.uptodate.com/contents/invasive-cervical-cancer-epidemiology-risk-factors-clinical-manifestations-and-diagnosis UpToDate. Updated: Jul 26, 2021.
[9] Alice Ma. Approach to the adult with a suspected bleeding disorder. https://www.uptodate.com/contents/approach-to-the-adult-with-a-suspected-bleeding-disorder UpToDate. Updated: Feb 19,2021.
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