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Mid Cycle bleeding


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#1 DiXie

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Posted 04 October 2010 - 08:09 AM

Hello Dr. Fiona,

I don't know if this question may be a bit out of your expertise but I will give it a try.

For almost 4 years now (when we started TTC and I stopped taking the BCP) I have been having irregular bleeding which starts a day or two after my ovulation and continues on until my period. So yes, shortly I bleed on and off for 2 weeks and more.

Of course most tests were done to find the solution but doctors could not find anything wrong...so they checked my hormones pre and post ovulation, done uterine byopsies etc etc. I never had that surgery type of testing (through the belly button)...
I had bleeding during my FET and at that time the doctor doing the transfer said he can not see any blood in my uterus (but that morning before the ET I had my bleeding).
Finally I did acupunture and that did not help either (maybe I did not do it long enough??) I did it for a month every week and then once monthly after my ovulation for about 6 months.


I just had a miscarrigae in August and since then my irregular bleeding has gotten even worse, while it was only spotting here and there and morning gushes of blood, no it is gushes of blood through out the 2 weeks.

I have an appointment to see my Family doctor about this in November (long waiting lists!!) but in the mean time can you think of anything that may answer my problems..any herbs I could take to control this bleeding?

I know it's a bit hard to determine what I should be taking as we don't know what the issue is...but I will try ANYTHING!

I would like to note that at the moment I am taking prenatal vitamin, eat as healthy as I can, and I was diagnosed with hypothyroidism about 8 years ago and have been taking 0.75 of synthroid for that long as well (with an increase around my IVF to 1.00mg in case I got pregnant).

I know we are shooting in the dark...but any insight will help me at moment as I am getting very depressed over this problem.

P.S. certain *ahem* positions during intercourse also cause me bleeding which goes away rather quickly but I thought it might be relevant...

This cycle:
Day 1 - Sep 2
Started bleeding - CD19
Next day 1 - Oct 2

Thank you in advance!

#2 Luckypenny

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Posted 04 October 2010 - 09:10 PM

Does it help if you take progesterone? I've read that saliva hormone testing is a better way to get a true idea of what is going on with progesterone because the level of progesterone in your blood isn't a true indictor of how much is making it to your tissues, where it is needed. Not sure if this is helpful, just a thought.

Have you had a lap to check for endo? I've read that endo can also cause bleeding, and can be painless so sometimes doctors don't think to check for it.

I've also heard that sometimes women respond better to some forms of progesterone than others (I think babyvibez mentioned this was the case for her, you could pm her).

I also remember that Lisa1995 said she always bled before she got her beta. You might want to check her signature. After her successful ivf the doctor put her on hcg support. She also did immunological testing that revealed two blood clotting disorders and something else - can't remember, maybe high NK cells.

I'm sure Dr. Fiona will have more ideas too. Good luck figuring it out, it can be frustrating when your body doesn't do what you know it should :(

#3 want2babies

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Posted 04 October 2010 - 10:24 PM

Hi Dixie,

sorry that you are going through this, it must be really tough for you. I jus had an IUI cycle (was converted from IVF), and I started spotting on my CD 20 (ovulated on CD 13). I was hoping it was implantation bleeding, but with more and more spotting that lead to bleeding, my heart sank each time I saw some streaks of blood. I ended up having an early period. I feel for you girl.

The reason for my spotting was low progesterone. It was 19 on CD 19 (should be > 25). my RE put me on progesterone suppositories, which I didn't absorb at all, and my progesterone kept on falling fast. I bumped into my RE in the hall way and we had a quick talk about this. He said my ovary (I only have one) shut down and didn't produce progesterone. He said it is normal for ovaries to shutdown like this (because of the stims), just most people don't do it this well and this fast like me (almost making me sound like i am doing well, but this can't be a good thing!). He mentioned that he will give me oral progesterone the next time, as they are likely to be more effective. I still don't quite understand the science behind all this. but I am mentioning this as this may be what you have as well? You said your doctor did your hormone tests? Was your progesterone level normal? I saw one lady here who said she was spotting during her cycle even when her progesterone was very high (at 90)...

You mentioned that your bleeding has gone worse, and it's gushes of blood for 2 weeks? There must be something wrong. If your doctor doesn't know what's wrong, maybe he/she is not looking hard enough. You probably want to consider seeing another specialist (RE or Gyn) and demand answers. I doubt it is something that your family doctor can know for sure. What does your RE say?

Best of luck Dixie, I hope you will get answers + fixes soon. (HUGS)

#4 DiXie

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Posted 05 October 2010 - 05:35 AM

Thank you for your help ladies!

all the hormones were checked before my first IVF at different stages of my cycle,, for this reason, and everything came back normal, funny enough while I was on meds after my IVF transfer I had no bleeding, I did mention this to my RE at that time and he dismissed it as I was full of mediction and that is why...EXACTLY!

I never did Lapo for Endo, my RE at OFC never thought I needed it...

it is my luck to run into doctors who don't care lol

I am going to my family doctor only because I can TELL him to refer me to OB/gyn for further testing.

I don't want go to OFC for this as I am out of province patient and have to pay for every visit....with the money I spend there I could go to Europe and see a doctor and have a nice vacation while there lol

#5 impatient

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Posted 05 October 2010 - 11:03 AM

Oh Dixie,

I'm so sorry to hear that you're going through this. Did I read that correctly that you have to wait until November to see your GP?! Is there someone else you can see or is there a walk-in clinic or emergency you can go to instead? Or, can you at least put in a request for a referal to a specialist without actually seeing your GP? I'm just thinking you'll probably have to wait even longer for that appointment and this sounds like a fairly extreme situation.

Back in the days when I thought BCP had a purpose, I used to get really bad bleeding on the pill (one week on, one week off) until I was changed to one with a different type of progesterone. I've also been told that the internal cells of my cervix grow on the outside and that that can cause spotting during sex and gynecological procedures - nothing like what you're describing though. I don't think endo usually causes external bleeding, but fibroids can.

I feel for you - that much bleeding really takes a lot out of you. Have you had your iron levels checked recently to rule out anemia? Take care of yourself. XXXXX
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#6 Cassandra_Angela

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Posted 05 October 2010 - 02:42 PM

I could have written your post WORD FOR WORD!!!!
I have done test after test and have gotten no answers either.

The only time that I didnt have the bleeding was when taking PIO while cycling.

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#7 DiXie

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Posted 05 October 2010 - 04:14 PM

Imaptient - They had one in October but I will be on holidays so november worked better for me lol, I can always go see him at the walk but nah I waited 4 years I can wait few more months...

Supermom - I hope Dr. Fiona will have some insight for us :)

#8 DrFionaMcCulloch

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Posted 05 October 2010 - 11:29 PM

Hi Dixie,
there are a few potential causes for this but the one that sticks out to me at first is that your progesterone is inadequate or unstable. This can often be caused by a poor corpus luteum. The health of the corpus luteum depends on the health of the follicle which develops in the follicular phase (first phase). Also if you did not have the bleeding during your IVF cycle, then it also points to progesterone being the cause of this. Like Lucky mentioned you can also have bleeding from endometriosis, or from polyps (though polyps should have been diagnosed from scan). You can also have bleeding midcycle from estrogen breakthrough but this doesn't sound like the problem in your case.
Endometriosis can only be diagnosed by laparoscopy ....however if you have very painful periods this is a potential symptom of this disorder. There are other symptoms too, and there are often signs which point to these kinds of conditions. I think this bleeding could really be a big part of the problem you are having which you probably instinctively feel!
Some questions to consider: If you are having bleeding during intercourse, is it the same type of bleeding or is this bleeding which stops after a day or so ? When you had bleeding before your FET was it going on just on the morning of the FET and had you ovulated already naturally during that cycle at that point - this could explain bleed then.

Blood testing for progesterone won't really be that accurate because blood tests test for "bound" hormones which are the hormones not available to receptors. Blood tests only give you a snapshot of one day, and often progesterone may be unstable, so it may be ok at one time and not at another which explains the ups and downs of the bleeding you're experiencing. You can either do salivary testing, or BBT charting - these can both be good tools for something like this. If you want to consult with me about your specific case feel free to email or pm me, and if I looked closely at your case I could give you a better idea of what is going on and what would be the best way to treat. The natural treatments for this would be to increase the quality of the follicle in the follicular phase so that your corpus luteum is healthier, and also to increase your progesterone to estrogen ratio. If there was endometriosis/clotting disorder then treatment would be different.

Thanks so much and I hope this was helpful for you!

Dr Fiona
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#9 DiXie

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Posted 06 October 2010 - 04:40 PM

hmmmmm interesting...now I am even more confused lol Wouldn't doctors notice that my corpus leutum was not good enough during my cycles??

I did charting while we were ttc-ing naturally few years back, my charts were exampleary, never nothing wrong with them...

Thank you for your response! I will see if my doc can send me for more hormone testing...

if I were going to try to better my CL what would that involve?? Might as well try if it wont hurt me...

#10 want2babies

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Posted 06 October 2010 - 05:21 PM

Hi Dixie again,

thought of something that may help you. When I was bleeding, my RE removed a clot/tissue that I shed down from my uterus/cervix (not sure where he got it from). He sent that tissue to the lab to see what that is. The lab result showed that it was a polyp, which made sense in my case (because i had a uterus polyp, and my hormone levels were normal). so if you are passing down clots, the lab can tell you what that is (i.e is it from uterus or cervix?). when my RE checked me, he said "it was just to make sure that I wasn't bleeding elsewhere". I guess he was talking about making sure I don't have other internal bleeding that we don't know about. Did anyone ever did a similar test to see where does the bleeding coming from? good luck! (and make sure that you get a doctor that CARES to find out what's going on. :) )

#11 want2babies

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Posted 06 October 2010 - 05:25 PM

me again. This is what I found on internet that is related to what Fiona was saying.

source: http://www.inciid.or...rtility101&id=7

"Should progesterone levels prove to be low, the temptation is often to "treat the symptom" by giving the patient progesterone supplementation during the luteal phase. In the case of inadequate corpus luteum performance, progesterone support may indeed be the appropriate solution. However, inadequate follicle development may also be causing the low progesterone levels. Thus, it is important to measure midcycle follicle size (via ultrasound) and estradiol levels (via a blood test).

If follicle development is normal, then progesterone supplementation during the luteal phase is normally the correct treatment. If follicle development is inadequate, an ovulatory stimulant such as Clomid or an injectable drug may be in order; these drugs help the follicle to mature more appropriately, which has the double benefit of producing a higher quality egg and a better-functioning corpus luteum.
Premature failure of the corpus luteum can occur even when the initial quality of the follicle/corpus luteum is adequate. For reasons not wholly understood, the corpus luteum sometimes does not persist as long as it should. Initial progesterone levels at five to seven days past ovulation may be low; even if they are adequate, the levels drop precipitously soon thereafter, again leading to early onset of menses."

#12 SangrealMazimur

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Posted 07 October 2010 - 08:46 AM

Hiya Dixie, I have the same issue as you exactly. My Gyno actually asked me one day during my pap if I had any pain or bleeding after sex, and I said yes sometimes...but I always had so I thought it was normal.

Well apparently I had a ton of blood vessels in my cervix...more than normal....He even took a picture (ew). Well 2 sessions where he cauterized them (at least a lot of them), and that problem is gone!

The bleeding after I ovulate isn't though. I'm going to bring it up with my RE when I see him on the 20th though. I have a feeling this is contributing with my losing my pregnancies.

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#13 Cassandra_Angela

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Posted 07 October 2010 - 03:37 PM

My RE suspected that it was from estrogen and suggested putting me on an estrogen patch starting around day 10 but then this month my estrogen is really high and yet I'm having the same problem again so I guess I blew his theory outta the water lol.

Personal Question Alert:

For those of you experiencing it, how did you and your DH cope with it and your sex life?
Do you get embarrassed or just grab a shower after etc ....

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#14 DiXie

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Posted 08 October 2010 - 06:23 AM

Thank you so much for your input!
At this point I will ask my Fam. Doc to do Saliva Progestorone testing vs b/w, or tell him to start me on progestorone to see if this is what is causing it.
I have feeling this is why I had my miscarriage...

As I said I went for regular u/s during my cycles cloths and polyps and such would have been noticed during the scans...I am ruling any of those out.

Supermom - I am usually not that much in a mood, as I said I am getting very very depressed over it every time it starts, I actually create a little bubble around me and try not to have contact with anyone during this time...sometimes we do go for it but very rarely, DH undestands and doesn't mind...he is such a dear :)

#15 ceci

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Posted 28 October 2010 - 08:06 PM

Hi, I had the same the problem. After the laparoscopy in March, I am bleeding almost every day. Not a lot, but enough to wear a pantyliner. I told this to the fertility DR, naturopathic and family Dr. No answers until I got an appointment with an endo specialist in Ottawa (after waiting 8 months). He suggested to do an ultrasound and hysterosonography to discard polyps. Well, today we found a polyp in the uterus. I did not have it back in March and it was not detected in the regular u/s for IVF. So, make sure to have an u/s to discard it.

I know it is frustrating, but don't give up until you get an answer!

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Nov - Dec 09: Baseline ultrasound, blood test etc etc.. Low antral follicle count, one blocked tube and ovarian cyst
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May-June 10: IVF # 1 - antagonist protocol, 2 transferred (6 cell grade 3), no frosties, BFN
Nov-Dec 10 : IVF # 2 - antagonist protocol + ICSI, 2 transferred (8 and 9 cell grade 3), no frosties, BFN....sigh....
May 2011: Surgery to remove endometrioma, cysts, adhesions, and tubes
Sept-Oct 11: IVF # 3 - antagonist protocol + ICSI, endometrioma grew back sad.png, 3 transferred (8 cell grade 3), no frosties, now waiting..14dp3dt Beta = 39616dp3dt Beta = 127721dp3dt Beta = 8693 ..U/S shows one sac/ no egg yolk and one irregular sac/no egg yolk (possible a sub chorionic bleed)..6w3d = 115 bpm + sub chorionic bleed8w3d = one little bean growing as expected : )18w1d = we are having a baby boy!!
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