Brown Pre and Post Menstrual Spotting

Question

I am 28 years old. For the first time in my life I noticed brown spotting before my period which lasted lasted for five days. When my period started in five days it lasted for 4-5 days until it was finished. I noticed again I have brown spotting and sometimes even slight bleeding. It’s been already ten days after my period finished I felt lower abdomen cramping and bloating which lasted only for several hours. I don’t feel any pain, just feel tired sometimes. I have an appointment next Thursday with my OBGYN doctor but before that I would like to hear your opinion what you might say about it. I am married and have normal sex life with my husband. Do you think it’s a miscarriage, pregnancy, infection or something else?
Thanks for your reply in advance

Nikkie

Answer

Last Updated: July 11, 2013
Dear Nikkie,

There are a number of possiblities which would explain your symptoms.

Was your period late when it started? If so, then a miscarriage may be possible. Usually, though, a miscarriage will be accompanied by more bleeding and cramping, but if it is early enough, perhaps not.

You may have had a cycle without an ovulation, or with a poor ovulation. This would result in either no progesterone (no ovulation) or inadequate progesterone (poor ovulation) produced in the latter half of your cycle. Without normal progesterone, your period will be abnormal. It may be accompanied by premenstrual spotting, post-menstrual spotting, and/or more cramping/bleeding than usual.

An ectopic pregnancy always should be considered any time you have an unusual period (especially a late one) accompanied by unusual pelvic pain. A pregnancy test can help exclude this. Any pelvic pain that is persistent and progressive should be evaluated right away.

The discomfort you felt ten days after your bleeding stopped could have been ovulation pains associated with the next cycle. These are called “mittelschmerz” pains, and are common with ovulation.

The fatigue you feel could be due to many different things, many unrelated to your menstrual cycles. Low progesterone could be playing a role here, though. The only way to test this is to check a series of progesterone levels targeted to your ovulation. If you find that you have more cycles like the one you described, then it may be worthwhile for you to chart your cycles using the Creighton Model NFP charting system, then have progesterone levels drawn on the 3rd, 5th, 7th, 9th, and 11th days following you peak mucus day. This will tell you if you would benefit from progesterone supplementation.

Dr. John Gisla

Answered By:

John Gisla, MD
Dr. John Gisla, Board Certified by the American Academy of Family Physicians, pracitces in the Sacramento Region.

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