Abnormal Bleeding: Insights on Ovulation and Pregnancy Chances

Abnormal bleeding

Hello, doctor.
My first menstrual period after giving birth was on April 12, and the second one was on May 19.
I took ovulation medication on May 21.
On the 13th day of my cycle (May 31), I went to the obstetrics and gynecology department for a follicle scan, but the doctor said they couldn't see anything.
After discussing, we thought that my cycle might be 35 days long, so the doctor advised me to come back for another scan in seven days.
I have been using ovulation test strips, but the lines have always been faint.

On June 3, I started bleeding, which was about the amount I would expect on the fourth or fifth day of my period, and it was brown in color.
However, on the evenings of June 4 and 5, the bleeding increased, and occasionally there was bright red blood.
As of today, June 6, there is still a little bit of brown discharge, and I went to see the obstetrician in the evening.
The doctor said it might be ovulatory bleeding, but after a transvaginal ultrasound, they still couldn't see a follicle.
The doctor mentioned that if I want to conceive this time, it might just be a matter of chance.
I would like to ask if this bleeding could indicate that I have already ovulated in the past few days, which would explain the ovulatory bleeding? I have felt quite warm in my body these days; could this be due to an increase in body temperature during ovulation? Additionally, if I have been sexually active during this time, what are the chances of becoming pregnant? Thank you.

Guan, 30~39 year old female. Ask Date: 2022/06/06

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is possible for your menstrual cycle to be irregular for a while after giving birth.
Just observe and let it happen naturally.
Wishing you good health.

Reply Date: 2022/06/06

More Info

Understanding abnormal bleeding during the menstrual cycle, especially in the context of trying to conceive, can be quite complex. Based on your description, it seems you are experiencing a phenomenon known as ovulation bleeding, which can occur around the time of ovulation. Let’s break down your situation and address your concerns regarding ovulation, bleeding, and the chances of pregnancy.

1. Ovulation and Bleeding: Ovulation typically occurs about 14 days before the start of your next menstrual period. However, cycles can vary significantly in length, and it appears that your cycle may be longer than the average 28 days. The bleeding you are experiencing on June 3rd, which is described as brown and then turning red, could indeed be ovulation bleeding. This type of bleeding is usually light and can occur when the follicle releases the egg, causing a small amount of blood to be released. It is often accompanied by other signs of ovulation, such as a slight increase in basal body temperature and changes in cervical mucus.

2. Interpreting the Bleeding: The fact that you are observing a mix of colors in your bleeding (brown and red) is not uncommon. Brown blood typically indicates older blood that has taken longer to exit the uterus, while fresh red blood can indicate more recent bleeding. If your doctor has suggested that this is likely ovulation bleeding, it is a good sign that your body is functioning normally in terms of ovulation.

3. Using Ovulation Prediction Kits: You mentioned using ovulation test strips and observing faint lines. These tests measure the surge in luteinizing hormone (LH) that occurs just before ovulation. If the lines are faint, it may indicate that you are approaching ovulation but have not yet surged. It’s important to continue testing daily, as the LH surge can be brief.

4. Chances of Conception: If you are indeed ovulating, the chances of conception increase significantly if you engage in intercourse during the fertile window, which is typically the five days leading up to ovulation and the day of ovulation itself. If you have been "doing the homework" (having intercourse) during this time, your chances of becoming pregnant are higher. However, keep in mind that even with perfect timing, conception can take time, and it’s normal for it to take several cycles for some couples.

5. Monitoring Symptoms: You mentioned feeling warm, which could be a sign of increased body temperature associated with ovulation. It’s beneficial to track your basal body temperature (BBT) daily, as a sustained rise in temperature can confirm that ovulation has occurred.

6. When to Seek Further Help: If your bleeding continues or if you experience any severe pain or other concerning symptoms, it’s important to follow up with your healthcare provider. They can perform additional tests, such as blood tests to check hormone levels or further imaging studies, to ensure everything is progressing normally.

In summary, while the bleeding you are experiencing could be related to ovulation, it is essential to continue monitoring your cycle and symptoms. Engaging in intercourse during your fertile window can increase your chances of conception. If you have any concerns or if your symptoms change, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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Hello, it is possible that you are experiencing ovulatory bleeding; please monitor the situation. Wishing you good health.

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