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Mid cycle cramping and bleeding

Sometimes women could experience mid cycle cramping with or without bleeding. If you have pelvic pain or abdominal pain or cramping in the middle of menstrual cycle, it could be just ovulation pain. Mid cycle cramping and bleeding could appear when dominant follicle ruptures and releases the egg. According to health experts, about 20% women experience some type of ovulation pain – commonly it is observed during puberty and perimenopause.

Mid cycle cramping (ovulation pain) has few typical characteristics:

  • It usually appears on 13-14- 15-16 days of menstrual cycle depending on duration of cycle;
  • Duration of ovulation pain is short (from few hours to 24 hours);
  • Ovulation pain usually appears suddenly and disappears fast (without any interventions);
  • Mid cycle cramping can be sharp;
  • Ovulation pain may switch sides from month to month (depending in which ovary ovulation happens);
  • Mid cycle cramping can range from a minor pinch or twinge that’s over in minutes to more severe cramping that lasts for hours;
  • Ovulation pain can be accompanied with brown discharge or short light bleeding.

Although most cases of mid cycle cramping and bleeding are connected with ovulation, there are several other causes which can trigger irregular bleeding and cramping (on different days of cycle). These symptoms could sometimes coincide with ovulation period and misdiagnosed as ovulation pain/bleeding.

Mid cycle cramping and bleeding – causes

Mid cycle cramping and bleeding

According to first theory, mid cycle cramping could be triggered by stretched surface of ovary (condition when follicle reaches its maximum size and ready to release the mature egg).

Some experts explain ovulation pain by little amount of blood and fluids released during ovulation and irritated peritoneum.

Ovulation pain is useful both for women who wants to conceive and women who wants to prevent unplanned pregnancy.

Concerning mid cycle bleeding, it can be explained by pre-ovulation spike of female hormones and drop of estrogen just before ovulation. Sharp estrogen fluctuations could cause local bleeding in endometrium (internal uterine lining).

In 85-90% cases mid cycle cramping and bleeding occurs because of ovulation and it should not be a subject for concern. But sometimes mid cycle cramping and bleeding could appear because of other causes which could have irregular character and could coincide with ovulation period.

During pelvic inflammatory disease (PID) women also could experience irregular cramping and bleeding but it usually have on-going character, combined with increased colored vaginal discharge, pelvic pain or severe abdominal cramping, fever and some other symptoms.

Sexually transmitted diseases such as trichomoniasis, Chlamydia and gonorrhea also could cause irregular cramping and bleeding. Typical symptoms of mentioned diseases include yellow or green vaginal discharge, foul vaginal odor, vaginal itching and burning sensation, frequent painful urination and more.

Some hormonal dysfunctions such as polycystic ovarian syndrome (PCOS), endometriosis, thyroid disturbances and diabetes also could change levels of female hormones (mainly estrogen) and trigger irregular bleeding or brown discharge and sometimes cramping.

Birth control pills, missed pills, intrauterine contraceptive devices (IUDs) and some vaginal contraceptives could also cause irregular bleeding or brown discharge between periods but in most cases it is not combined with cramps.

Urinary tract infections (UTI) may also be confused with mid cycle ovulation pain. The close proximity of the urinary organs to the female reproductive organs makes it difficult to differentiate between one another. Most typical symptoms of UTI include frequent urination, pain or burning sensation during urination, colored urine and back pain.

Rare constipation and digestive diseases could cause mid cycle cramping which almost never combined with bleeding in the middle of menstrual cycle.


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