Bleeding in the middle of my cycle around ovulation

[namechange1409]

For the last three periods I've had bleeding during ovulation. The first time it was proper bleeding, albeit fairly light, but enough to need to wear a pad day and night for 3 days. The second time it was a tiny bit of a spotting. I then had one month with no mid-cycle bleeding and then today (day 14 of my cycle) I've started bleeding - bright reddish brown blood that feels like the start of my period. It's always when I'm ovulating and lasts 3 days max.

I'm 31, not currently sexually active, not on any hormonal contraceptives. My periods are regular, albeit around 35 days apart so on the longer side. I'm pretty sure I have PCOS as I have facial hair I have to remove daily and I seem to get blood sugar crashes a lot. My BMI is 31. I have had a lot of weight fluctuation this year. Between December and February I lost 2 stone from stress, and then since February I've gained 3 stone. I can tell I've gained weight in the last few weeks as my jeans are tight and I've been getting boils and painful acne, which is my sign that I've been eating too much sugar.

I've decided to lose weight and look after myself more. Do I need to go to the GP or can I wait to see if it happens next month after a month of healthy eating? I really don't want a pelvic examination or internal ultrasound.

I would say you need to see your GP, if you do have PCOS you need to have 2 out of all the 3 symtpoms which does require tests. You like have excess male hormones if you have hair growth, however they'd need to check by a scan about the polycystic ovaries and lots of small follicles (that can be via pelvic and transvaginal ultrasound or MRI) and then they'd need to check about ovulation dysfunction - do you have irregular periods?

You'd need a blood test to check Hormone levels and then cholesterol as well

I would see your GP as PCOS can cause issues with insulin sensitivity so you may need to get help from that side of things. Something like metaformin etc can be helpful to regulate blood pressure etc. To try and regulate ovulation etc the mirena coil is the form of treatment or contraceptive pill. This can also help to make sure your uterus lining doesn't get top thick preventing endometrial cancer.

They can also prescribe some creams or other things for the excessive hair. Then you may also need to try some medication to help with weight loss as it can be harder if you have PCOS, something like orlistat. Statins can also be used if you have high cholesterol issues. But to know that you'd need to see your GP and get some blood tests done so then you can come up with a plan for the long-term.

As a note pelvic and transvaginal ultrasounds don't hurt, even for a TV you can just feel it but it's not painful or anything. The gel for your pelvic ultrasound is a little cold but only for a second or two. There's also a chaperone with the sonographer, so you won't be alone with one person. It's also pretty quick so I wouldn't let that be the barrier to you getting some help. I'd make am appointment with your GP as soon as you can, don't wait a month. Perhaps ask reception or check the website if there's a GP with an interest in endocrinology or women's health.

Thank you. I'll have a think about booking a GP appointment, I'm just really nervous about any examination. I do have really regular periods, every 35 days.

I feel like I've been thinking that the bleeding is because of my weight fluctuations - more specifically, my recent weight gain. I can feel that my hormones are all over the place with my hormonal acne being worse at the minute. My last period was different too - it seemed to take ages to actually start, and I didn't have sore boobs which I always get just before my period.

But sometimes weight fluctuations and acne, excessive hair comes with PCOS, so getting that managed can make it better. Even if the bleeding is coming from there, it's better to do a joint approach and try something like tranexamic acid, ask your GP to prescribe it as it massively helps with bleeding etc.

Don't be nervous, maybe if you have one of those online forms, then you put it in there, so it's easier in the actual appointment. I really would make an appointment as soon as you can though, if you care about your health and managing it we'll, you need to. I'd be pushing for a pelvic and transvaginal ultrasound (they can be done in the same appointment/scan). You need the GP to refer you for one and then make sure they also refer you for hormonal blood tests and then some for cholesterol etc. Ask them specifically about making sure they cover all the bases so that you can get the diagnosis for PCOS and then deal with the management. Often things like the mirena coil can be amazing to balance it all out and help with more regular ovulation and keeping the bleeding low as well. I'd really look into getting one, ask your GP about it at the appointment if you can.

Perhaps if you do have an online from you can reference some of the stuff from this post and my last one in terms of the scans and further investigations you need and the medication management, as well as your description of symtpoms. I'd write a list of everything you want to cover on your phone notes app etc and make sure you go through them all in the appointment.

Also ask about medications or creams to help with the excessive hair growth, and then once your results for bloods come back ask about trying metaformin and orlistat as well - I'd bring it up in the inital appointment before the bloods are back to see if they're happy yo try one of them depending on the blood results.

The GP won't do any examinations by the way, there's nothing to do, in terms of the ultrasounds that would be a seperate referral for a scan which you need to make sure your GP books for you even if you are nervous, it's so important for the diagnosis. They'll be a sonographer and then a chaperone when you have it, it doesn't hurt, and they'll ask you before they do anything. I'd really book this GP appointment as you won't get any better or make much progress for long-term management without it.