What causes bleeding during ovulation?

Generally, the main causes of ovulatory bleeding include hormonal fluctuations, local endometrial reactions, cervicitis, endometrial polyps, and submucosal uterine fibroids. If discomfort symptoms occur, it is recommended to seek timely medical consultation and treatment at a regular hospital. Detailed explanations are as follows:

1. Hormonal Fluctuations

During the ovulatory period, a temporary decrease in estrogen levels leads to partial shedding of the endometrium due to lack of hormonal support, resulting in slight bleeding, often spotting, lasting for 1-3 days. In daily life, it is important to maintain a regular schedule, avoid staying up late and excessive fatigue, keep emotionally stable, and reduce hormonal fluctuations. During the bleeding period, attention should be paid to external genital hygiene and avoidance of strenuous exercise. Usually, no specific treatment is required, and symptoms can resolve spontaneously.

2. Local Endometrial Reaction

In some individuals, the endometrium is highly sensitive to hormonal changes. Even a slight decrease in estrogen levels can cause localized endometrial shedding and bleeding, characterized by heavy bleeding for a short duration. Under a doctor's guidance, medications such as estradiol valerate tablets, conjugated estrogens tablets, or drospirenone ethinylestradiol tablets can be taken to supplement estrogen, stabilize the endometrium, and reduce bleeding episodes.

3. Cervicitis

Cervicitis occurs when the cervix is infected by bacteria or viruses, causing inflammation. During the ovulatory period, cervical congestion is evident, and the inflammation may cause damage to the cervical mucosa, resulting in bleeding, often accompanied by increased vaginal discharge and odor. Under a doctor's guidance, medications such as azithromycin dispersible tablets, cefaclor capsules, or doxycycline hydrochloride tablets can be taken to eliminate pathogens and control inflammation. Additionally, it is important to avoid unhygienic sexual practices and abstain from intercourse during treatment to prevent cross-infection.

4. Endometrial Polyps

Endometrial polyps form due to localized excessive growth of the endometrium. Hormonal changes during the ovulatory period can stimulate the shedding of the endometrium covering the polyps, leading to bleeding that lasts longer and may be accompanied by abdominal pain. Under a doctor's guidance, medications such as dydrogesterone tablets, progesterone capsules, or norethisterone tablets can be used to inhibit polyp growth. If the polyps are large or medication proves ineffective, hysteroscopic endometrial polypectomy may be required.

5. Submucosal Uterine Fibroids

Submucosal fibroids grow into the uterine cavity, and their surface mucosa is fragile. Uterine contractions or hormonal changes during the ovulatory period can easily cause mucosal damage and bleeding, often with heavy bleeding that may affect the menstrual cycle. Under a doctor's guidance, medications such as mifepristone tablets, danazol capsules, or triptolide capsules can be taken to reduce the size of the fibroids. If the fibroids are large or symptoms are significant, hysteroscopic resection of submucosal fibroids may be necessary, followed by follow-up examinations as directed by the physician.

In daily life, attention should be paid to menstrual hygiene, including frequent changing of sanitary products; avoid frequent vaginal douching to prevent disruption of the vaginal flora balance; undergo regular gynecological examinations to detect cervical and uterine abnormalities early; and seek immediate medical attention if bleeding increases, abdominal pain worsens, or bleeding lasts more than 7 days to avoid delaying treatment.