For the majority of women, ovulation takes place with the utmost discretion. In others, on the other hand, it manifests itself by small bleeding, which is not alarming. In principle, however, it is advisable to consult in case of bleeding between periods.

Some women experience small bleeding in the middle of their cycle. This bleeding is not pathological. It is assumed that they are due to the physiological phenomenon of ovulation: the tension of the ovarian follicle fluid increases and ends up causing the rupture of the follicle and the expulsion of the oocyte. Sometimes, the rupture of the follicle is sudden and causes that of a small blood vessel, at the origin of these small benign bleeding.

Bleeding from ovulation is sparse and has nothing to do with the flow of your period. Often, these are just traces of blood, or spotting, which will last a few hours, or even one to two days. They may be accompanied by a slight pain or tension in the lower abdomen, usually on one side only (that of the ovary, the site of ovulation for this cycle).

There are other causes of metrorrhagia (bleeding between periods) or spotting (small traces of blood between periods):

• a small wound in the cervix, following sexual intercourse, vaginal examination or a cervical smear. The bleeding is then generally weak and will stop spontaneously. Likewise, a sore in the vagina or an infection can cause bleeding;
• hormonal disturbances that can be induced by psychological stress;
• poorly adapted or poorly tolerated hormonal contraception. Anarchic bleeding can occur under micro-progestogens (pill, implant, hormonal IUD) when they prove to be insufficiently dosed for the woman, and even under estrogen-progestogen. Bleeding between periods is also frequently observed with a hormonal IUD;
• forgetting the pill (especially micro-progestogen);
• endometrial lining atrophy after several months or years of taking the pill. Transient intake of an estrogenic pill will regenerate the mucous membrane.

Bleeding between periods is usually mild, and most often due to hormonal imbalance, or even ovulation if it occurs in the middle of a cycle. In principle, however, it is advisable to consult in case of bleeding between periods, a fortiori if they are accompanied by pain. It is important to rule out uterine fibroid, polyp, miscarriage, ectopic pregnancy, genital infection, and even cervical cancer.