mid-cycle bleeding

Hi-

I hope you can help me.  Let me begin by saying I have been having irregular periods for a year and a half.  At first, I was skipping periods.  This happened twice.  I notified my ob/gyn, and they prescribed a hormone medication (can't remember what it was) to "jump-start" my periods.  It worked each time.  Then, beginning earlier this year, I started having mid-cycle bleeding.  My periods were regular, but in between each, I would have 2-3 days of spotting.  It has been anywhere from brownish to reddish.  Today it was pink.  I was not taking any birth control pills when this began.  I have notified my ob/gyn about this as well, and they have prescribed birth control pills for me to take to regulate my periods.  I have not started these yet.  I had a pap-smear done a week ago, and I am still awaiting the results.  They have also tested my thyroid levels, because I have a history of post-partum thyroiditis, and they want to rule this out as a cause for the irregular bleeding.  Otherwise, they told me it is probably just stress induced.  However, my appointment was a week ago, and this bleeding happened again yesterday.  I have calculated it to be exactly 14 days from my last menstrual period, so I believe it must have something to do with ovulation.  I am afraid to call my ob/gyn again, because I feel I am starting to get on their nerves by calling too much!

I want to know if this is normal to spot during ovulation, and what are the causes of this?  I have looked elsewhere on the internet, but haven't found any definitive answers.  I would also like to know why this would suddenly start happening over the last few months when it has never happened before.  I am 26 years old, and have two children from normal pregnancies.  I also have fibrocystic breast disease.  I am also under high stress because I am finishing up my nursing degree, and will be graduating this December.  Thanks in advance for your help!

[Elaine Brown, MD]

Hi!
First of all, I must say that you do have some significant stress!
If you were my patient, I would test the same things that your doctor has done.
Our office policy is to send copies of results to the patients.  I'm certain that your doctor's office would not mind if you requested the results.

I would also prescribe oral contraceptive pills for cycle regulation.  A few thoughts about what might be causing the bleeding.  Some women have bleeding at ovulation time because of a dip in the estrogen level.  Other things that can cause mid-cycle bleeding are endometritis, endometriosis, polyps, and abnormal pap smears.

If the oral contraceptives don't work for my patients, I proceed to investigate some of the things listed above.
Hope this helps!

Dr B

[joycea]

I would also like to add that I am having cramping along with the spotting.  Also, they said they would call me if the pap-smear or the thyroid levels were abnormal, and otherwise I would receive the results in the mail, so I feel that after a week they are probably most likely normal.  I have also been tested during each pregnancy for STI's, and the results have been negative, so I am not concerned about this since I am married and in a monogamous relationship.