Abnormal Bleeding

Throughout the course of most women’s lives, there will come a time when she experiences abnormal vaginal bleeding when she is not expecting the onset of her menstrual cycle. And although in many cases, mid-cycle spotting is perfectly benign, it always bears further observation and attention. If you’re experiencing mid-cycle bleeding, make notes about how frequently it occurs, how much blood there is as well as its color, and any other symptoms that might be relevant. These will all provide useful information for your doctor during the diagnostic process.

There are many possible causes for mid-cycle bleeding. The Board Certified gynecologists at Commonwealth OB-Gyn, located in Brookline Village near downtown Boston, MA have extensive experience with the delicate hormonal balance of the female reproductive system, and utilize the most advanced diagnostic tools to help determine the possible underlying causes of mid-cycle bleeding.  Our team of warm, caring practitioners can identify a range of causes that may be causing your bleeding, including:

  • Cervical abnormalities
  • Irritation from sexual intercourse
  • Endometriosis
  • Adjustments from use of progesterone creams
  • “Implantation” bleeding from pregnancy
  • Ovulary complications
  • Adjustment to herbal treatments
  • Ovarian cyst or cystic rupture
  • Hormone imbalances
  • If you are concerned about mid-cycle bleeding, the team of experienced professionals at Commonwealth OB-Gyn can comfortably and reliably diagnose the underlying cause of the bleeding, and set you on the right track for optimal reproductive wellness.


    Endometrial Biopsy—What to Expect

    An endometrial biopsy is one of the most advanced diagnostic tools available today, and is usually a highly effective method of determining the causes of mid-cycle bleeding. During the biopsy, a small piece of uterine tissue will be removed from the wall of the uterus. That tissue will be taken to a lab and examined for specific signs that will help your doctor diagnose the root cause of the bleeding you are experiencing.

    To acquire the needed uterine tissue, a speculum is inserted into the vagina and opened to allow the doctor to see the cervix. A numbing spray (lidocaine) may be applied to the cervix if doctor and patient judge that pain medication may be needed.  A small metal or plastic device is then inserted into the uterus through the cervix, removing a small piece of tissue. If cramping occurs following the procedure, over-the-counter analgesics such as ibuprofen may be used to reduce any discomfort.

    The procedure is generally risk-free, and can be performed comfortably at your doctor’s office. An endometrial biopsy can be used to:

    • Diagnose causes of mid-cycle or post-menopausal bleeding
    • Identify cancerous cells
    • Detect the presence of pre-cancerous cells
  • Diagnose endometriosis
  • Evaluate the progress of treatments
  • Identify causes of infertility
  • What is Endometriosis, and How Do I Know if I Have It?

    Endometriosis is a condition in which tissues which normally reside within the uterine walls (the endometrium) find their way outside the uterine confines and begin to grow, sometimes causing very painful symptoms in the lower abdominal region. Because the endometrial tissue is designed to break down once a month during a woman’s menstrual cycle, these out-of-place endometrial cells continue to thicken, then break down and bleed with every monthly cycle. However, since these cells are located outside of the uterus, the blood and tissue that they discharge once a month has no means of egress—and so it remains trapped within the abdominal cavity, often causing irritation to other surrounding organs.

    The primary symptom of endometriosis is pain in the lower pelvic region—usually during menstruation, and sometimes quite intense. Other symptoms of endometriosis include:

    • Extremely painful periods—sometimes characterized by a period of cramping that begins before the initiation of menstrual bleeding, extending beyond the cessation of bleeding.
    • Infertility—many women seeking fertility treatments come to discover that their difficulty conceiving is the result of endometriosis.
    • Painful intercourse—women with endometriosis often experience pain during and after sexual intercourse.
    • Heavy periods—many patients with endometriosis experience heavy bleeding during their periods, and sometimes in between menstrual periods (mid-cycle bleeding).
    • Painful urination and bowl movements—typically, occurring during menstruation.

    If you’re experiencing any of these symptoms along with your mid-cycle bleeding, it is best to see a doctor as soon as possible. The health professionals at Commonwealth OB-Gyn can help diagnose your condition, and offer you a range of solutions.


    Contact Commonwealth OB-Gyn

    If you are concerned about abnormal, mid-cycle bleeding and would like to follow up with one of our Board Certified gynecologists, or if you would like to learn more about Commonwealth OB-Gyn, our physicians, and our other services, we encourage you to schedule your appointment today.  We look forward to hearing from you!

    Commonwealth Ob-Gyn