Why Am I Bleeding Again a Week After My Menstrual Cycle Ended?

Generally, the menstruation of healthy women lasts for 3-7 days before entering the ovulation period. However, some women may experience bleeding from the vagina a week after menstruation ends. This is actually caused by bleeding during ovulation, which is usually due to hormonal issues in the body. The bleeding usually lasts for a few days and the amount is not significant. However, if the bleeding persists for a longer time, it is recommended to consult a doctor for further examination.

Bleeding during ovulation occurs in the middle of two regular menstrual cycles, when the estrogen level temporarily drops due to ovulation, causing the endometrium of some women to lose support from estrogen and undergo detachment, resulting in regular vaginal bleeding. This is known as bleeding during ovulation, and in traditional Chinese medicine, it is referred to as "intermenstrual bleeding".

The clinical manifestations of bleeding during ovulation typically occur on the 12th to 16th day of a regular menstrual cycle, lasting for several hours or 2-3 days, not exceeding 7 days. The amount of bleeding is significantly less than a normal menstrual bleeding, and it usually stops spontaneously. It may be accompanied by mild discomfort in the lower abdomen or soreness in the waist, or may occur without any discomfort. Occasionally, it may occur between one menstrual cycle and the next, and in some individuals, it may persist for a longer period of time, occurring during 4-5 menstrual cycles.

1. Specialized gynecological examination: Pay attention to the presence of cervical erosion or bleeding, and if necessary, conduct a cervical TCT examination. Check for tenderness, thickening, or masses in the uterus and bilateral adnexa. (The examination should be performed gently when necessary.)

2. Auxiliary examination:

• Signs of ovulation: Biphasic basal body temperature, normal ovulation detected by B-ultrasound, and ovulation changes visible on ovulation test paper. Bleeding occurs during the transition from low to high body temperature and when the test paper changes from positive to negative, which corresponds to the ovulation period.
• B-ultrasound examination to rule out other diseases that may cause abnormal bleeding, such as endometrial polyps or submucosal uterine fibroids.
• Hysteroscopy: If necessary, hysteroscopy can be performed to rule out organic lesions such as cervical endometrial polyps or endometrial cancer.

Bleeding during ovulation usually occurs occasionally with a small amount of bleeding, sometimes only presenting as coffee-colored discharge. Most cases stop spontaneously within 2-3 days and can be observed without intervention. However, for women who experience persistent bleeding during ovulation, it can interfere with conception. Therefore, it is necessary to consult a doctor for appropriate treatment after ruling out other underlying diseases.