Unusual Bleeding: Cupping, Ovulation, and Implantation Issues

Massage cupping, abnormal bleeding, ovulation bleeding, implantation bleeding?

Hello Dr.
Huang: Thank you for taking the time to respond despite your busy schedule.
I am currently abroad and would appreciate your help.
I started experiencing a natural miscarriage on November 20, 2017, which lasted until November 28.
After that, I had my first menstrual period on December 19, which ended on December 25.
Following that, I had intercourse from December 26 to December 29.
On the morning of December 31, I went for a massage and cupping therapy due to persistent lower back pain.
After returning home on December 31, about 4 to 5 hours later, I noticed some light spotting, which stopped after about 1 to 2 hours.
However, the next morning, January 1, I experienced some slight bleeding again, and by the afternoon, it was almost gone, with only a drop or two when I used the restroom.
This morning, January 2, I woke up to some light bleeding again, which appeared as a thin line rather than spots.
The amount of blood is noticeably slightly more than the previous two days, but it stopped again by the afternoon.
None of these bleeding episodes have been accompanied by significant abdominal pain, though I did experience a couple of instances of mild cramping.
Additionally, from December 31 to January 6, according to my mobile app, this period coincides with my estimated ovulation period.
I would like to ask if this bleeding could be related to the massage and cupping therapy, or if it might be ovulation bleeding? Is there a possibility that it could be implantation bleeding from a potential pregnancy? Also, after this bleeding (which coincides with my ovulation period), will I still ovulate normally? Thank you in advance for your response!

Matcha, 30~39 year old female. Ask Date: 2018/01/02

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The natural miscarriage bleeding started on November 20, 2017, and ended on November 28.
After that, the first menstrual period occurred on December 19 and ended on December 25.
Following this, there were sexual encounters from December 26 to December 29.
On the morning of December 31, due to persistent lower back pain, I went for a massage and cupping therapy.
After returning home on December 31, about 4 to 5 hours later, I noticed some light bleeding from the genital area, which stopped after about 1 to 2 hours.
However, the next morning on January 1, there was some slight bleeding again, and by the afternoon, it was almost gone, with only a drop or two noticed when using the restroom.
On the morning of January 2, I woke up to some light bleeding again, which appeared as a thin line rather than spots.
The amount of bleeding was noticeably slightly more than the previous two days, but it stopped again by the afternoon.
None of these bleeding episodes were accompanied by significant abdominal pain, only a few instances of a dull, cramping sensation in the abdomen.
Additionally, from December 31 to January 6, this period coincides with my estimated ovulation period calculated by my mobile app.
I would like to ask the doctor if this bleeding is related to the massage and cupping therapy? Answer: The bleeding is unrelated to the massage and cupping therapy, or it could possibly be ovulation bleeding? Answer: Is it ovulation bleeding, or could it be implantation bleeding due to a possible pregnancy? Answer: It is unlikely to be implantation bleeding from a pregnancy.
Furthermore, after such bleeding (which coincides with the ovulation period), will I still ovulate normally? Answer: Yes, you will.

Reply Date: 2018/01/02

More Info

Unusual bleeding can be a source of concern for many women, especially when it occurs outside of the regular menstrual cycle. In your case, the bleeding you experienced after a natural miscarriage and subsequent sexual activity raises several important considerations.
Firstly, it is essential to understand the potential causes of the bleeding you described. Given the timeline, the bleeding could be attributed to several factors, including ovulation bleeding, implantation bleeding, or even a reaction to the massage and cupping therapy you underwent.

1. Ovulation Bleeding: Ovulation bleeding is a common phenomenon that occurs in some women around the time of ovulation, which typically happens about 14 days before the start of the next menstrual period. This type of bleeding is usually light and may appear as spotting or a small amount of blood. It is caused by a slight drop in estrogen levels just before ovulation, which can lead to a small amount of the uterine lining shedding. Since you mentioned that the bleeding coincided with your calculated ovulation period, this could be a plausible explanation.

2. Implantation Bleeding: If you had unprotected intercourse during your fertile window, there is a possibility of conception. Implantation bleeding occurs when a fertilized egg attaches itself to the lining of the uterus, usually occurring about 6 to 12 days after conception. This bleeding is typically light and can be mistaken for a light period. If you suspect that you might be pregnant, it would be advisable to take a home pregnancy test to confirm.

3. Effects of Massage and Cupping: The massage and cupping therapy you received could also be a contributing factor to the bleeding. These therapies can stimulate blood flow and may lead to minor bleeding, especially if there was any pressure applied to the abdominal area. While it is generally safe, it is essential to communicate with your therapist about any recent pregnancies or miscarriages, as this could influence the treatment approach.

4. Hormonal Factors: After a miscarriage, it can take some time for your hormonal levels to stabilize. This fluctuation can lead to irregular bleeding patterns as your body adjusts. If the bleeding persists or becomes heavier, it may indicate that your body is still recovering from the miscarriage or that there are other underlying hormonal imbalances.

5. Next Steps: Given the complexity of your situation, it is crucial to monitor your symptoms closely. If the bleeding continues or worsens, or if you experience significant pain, it would be wise to consult a healthcare provider for further evaluation. They may recommend an ultrasound or blood tests to check your hormone levels and ensure that there are no complications from the miscarriage.

In conclusion, while the bleeding you are experiencing could be related to ovulation or implantation, it is essential to consider all factors, including recent medical history and treatments. If you have any concerns about your health or if the bleeding persists, seeking medical advice is always the best course of action. Remember to take care of yourself during this time, and don't hesitate to reach out for support from healthcare professionals.

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