The term ‘spotting’ refers to the presence of mild bleeding that does not correspond to menstruation and that occurs between the menstrual cycle and the next one. Generally, it does not require menstrual products, since the amount of blood is minimal and hardly stains the underwear.
Main causes of spotting and its effect on fertility
1. Ovulation
Some women experience light bleeding during ovulation. In most cases, this is a physiological process caused by the temporary decrease in oestrogen prior to ovulation, which can cause a slight detachment of the endometrium. Once progesterone production increases, the endometrium stabilises and the bleeding stops.
In addition, during ovulation, blood flow increases at the level of the cervix, which can increase capillary fragility and lead to slight bleeding.
This type of spotting does not usually affect fertility, and in fact, in some women it can be an indicator of ovulation.
2. Hormonal imbalances
Any alteration in hormone levels during the menstrual cycle, especially in oestrogen and progesterone, can destabilise the endometrium and cause intermenstrual bleeding.
For example, insufficient production of progesterone by the corpus luteum can cause spotting before menstruation. Its presence may be indicative of an unstable endometrium, which could hinder embryo implantation.
3. Infections
Some sexually transmitted diseases, such as gonorrhoea, chlamydia or bacterial vaginosis, can inflame both the uterus and the cervix and cause intermenstrual bleeding.
When these infections are not diagnosed and treated in time, the risk of pelvic inflammatory disease, a condition that can affect fertility, increases.
4. Medical conditions related to the endometrium
Pathologies such as adenomyosis, fibroids or the presence of endometrial polyps can also be the underlying cause of spotting. These processes can hinder embryo implantation and increase the risk of implantation failure or early miscarriage.
The importance of knowing and monitoring the menstrual cycle
Understanding the menstrual cycle is fundamental for gynaecological health and fertility planning. Here are some strategies for monitoring it:
- Use of mobile applications: recording menstrual symptoms allows irregular patterns to be identified.
- Measuring basal temperature: taking it every morning before getting up helps to detect ovulation, when the temperature increases between 0.3ºC and 0.5ºC. Few women use it because it is uncomfortable, and if the cycles are regular, it is most likely that you are ovulating in the middle of the cycle.
- Observation of cervical mucus: its texture and appearance vary throughout the cycle.
- Use of ovulation tests: these allow detection of the luteinising hormone (LH) peak, which occurs 24-36 hours before ovulation.
Although most cases of spotting are benign and do not affect fertility, in some cases they can be a sign of infections, hormonal imbalances or endometrial alterations that can cause reproductive problems. Therefore, in case of any abnormal bleeding, it is advisable to see a specialist who can assess its cause and effect on fertility.
Dr. Cristina Guix
Gynecologist specialized in fertility at Barcelona IVF
