She appeared to be having two periods every month.
Sarah’s cycles were so short that her “first” period would last five days with normal flow, followed by a second “period” just a few days later. This second bout of bleeding was lighter, accompanied by clear, stretchy discharge and a sharp, pulling sensation in her lower abdomen.
By analysing herBasal Body Temperature (BBT) and using ovulation tracking, we discovered that Sarah wasn’t having two periods. She was experiencing ovulation bleeding – and because she assumed it was a period, she was avoiding intercourse during her most fertile window.
So, What is Ovulation Bleeding?
Ovulation bleeding is light bleeding or spotting that occurs during ovulation.
The exact cause of ovulation bleeding is not clear, but it is thought to be related to changes in hormone levels that occur during ovulation. The surge in oestrogen and luteinising hormone that triggers ovulation can cause some women to experience spotting or light bleeding.
Traditional Chinese Medicine (TCM) looks even deeper into the energetic shifts of the cycle.
The TCM Perspective: Yin, Yang, and the Chong/Ren Vessels
In Chinese Medicine, the menstrual cycle is a rhythmic dance between Yin and Yang. Ovulation marks the pivotal transition where Yin reaches its peak and transforms into Yang.
When a patient experiences ovulation bleeding, it often signals a “disharmony of the transition.” Key TCM patterns include:
Kidney Yin Deficiency: If Yin is insufficient, it cannot clear the “Empty Heat” that arises during the mid-cycle transition. This heat can destabilize the Chong and Ren vessels (the “Sea of Blood” and “Conception Vessel”), causing blood to leave its path prematurely.
Damp-Heat in the Lower Jiao: Lingering dampness or heat can obstruct the flow of Qi, leading to mid-cycle spotting accompanied by the “stretchy” mucus or “ovulation pain” Sarah experienced.
Spleen Qi Deficiency: If the Spleen Qi is too weak to “hold” the blood within the vessels during the energetic surge of ovulation, spotting can occur.
Does Ovulation Bleeding Affect Fertility?
Ovulation bleeding is generally not a concern; however, it may affect chances of getting pregnant naturally. For instance, Sarah thought that she was having period. She avoided having intercourse during that period time, therefore missed her fertile windows and had difficulty to get pregnant.
How We Support Hormonal Balance
At our Coburg and Ringwood clinics, we use a combination of Acupuncture and Chinese herbal medicine to regulate the Chong and Ren vessels, and help fertility.
For Sarah, we focused on:
Nourishing Kidney Yin to cool the blood and provide a smooth transition into the luteal phase.
Strengthening the Spleen to ensure the vessels could properly contain the blood.
Regulating Qi to resolve the sharp ovulation pain.
After a few months of treatment, Sarah’s mid-cycle spotting ceased. With her “fertile window” now clear, she was able to time intercourse correctly. Within three months, she successfully became pregnant.
FAQs About Mid-Cycle Spotting
Is ovulation bleeding the same as an irregular period?
No. A period is the shedding of the uterine lining. Ovulation bleeding is a hormonal “blip” occurring mid-cycle, usually around Day 14–16.
How can I tell the difference?
Tracking your BBT is essential. A true period is preceded by a drop in temperature, while ovulation bleeding occurs right as the temperature begins to rise.
Can acupuncture stop mid-cycle spotting?
Yes. By balancing the Yin/Yang transition and supporting Kidney essence, acupuncture helps stabilize the hormones responsible for mid-cycle changes.
Start Your Journey to Balanced Health
If you are experiencing “two periods in one month” or struggle with cycle irregularities, don’t let it stand in the way of your fertility goals. At Almond Wellness Centre, we combine 30 years of clinical experience with traditional wisdom to help Melbourne families achieve their dreams of parenthood.
Disclaimer: While many patients see positive outcomes with TCM for fertility, results vary. Always consult with your fertility specialist and a registered TCM practitioner before beginning new treatments.
An estimated 15% of couples in the world suffer from infertility. According to a survey in 2013 by the National Institute of Health and Clinical Optimization (NICE) in the United Kingdom, male factors have become the main reason for infertile couples to use assisted reproductive therapy (ART).
Male infertility is mainly diagnosed by routine semen analysis (WHO standard), including semen volume, concentration, vitality and morphology.
Although studies have shown that semen quality and ART outcome are correlated, until now, we have not found a conventional semen threshold that can predict the success of ART.
Recent studies have shown that sperm DNA fragmentation (SDF), including sperm DNA single-strand breaks and double-strand breaks, are all related to male infertility factors, which can adversely affect the male reproductive system and increase the risk of genetic diseases in offspring .
Two previous Meta-analysis studies have shown that SDF is related to ART failure and repeated pregnancy loss.
However, human sperm itself does not have DNA repair activity (DRA). Once fertilised, DRA mainly depends on the transcripts produced during the maturation of the oocyte to repair it. The ability of oocytes to repair SDF depends on the degree of fragmentation of SDF and the quality of oocytes.
Therefore, reproductive medicine researchers from Sao Paulo, Brazil, conducted research on women’s age and SDF and the outcome of intra-cytoplasmic sperm injection (ICSI) assisted pregnancy.
Amanda Souza Setti et al. collected 540 couples who underwent ICSI at the centre from May 2017 to December 2019, and divided the ICSI cycle into three groups according to the age of the woman: ≤36 years old (285 cases), 37-40 years old ( 147 cases) and >40 years old (108 cases).
Sperm chromatin diffusion test was used to evaluate the SDF of semen specimens.
For each age group, according to the SDF index, the ICSI cycle is divided into two subgroups: low fragmentation index (SDF <30%) and high fragmentation index (SDF ≥ 30%).
Summarised and analysed the outcome indicators such as embryo implantation rate, pregnancy rate and abortion rate.
The study found that: for young patients (36 years old) and patients between 37-40 years old, whether SDF <30% or SDF ≥ 30%, the laboratory and clinical results of the ICSI cycle were not significantly different.
When female patients are older than 40 years old, compared with SDF<30%, in an ICSI cycle with SDF ≥ 30%, the rate of D3 high-quality embryo acquisition (54.4% vs 33.1%) and the rate of blastocyst formation (49.6% vs 30. 2%), pregnancy rate (20.0%vs7.7%) and implantation rate (19.7%vs11.9%) were significantly reduced, while miscarriage rate (12.5%vs100.0%) increased.
Results
This study showed older oocytes, when injected with sperm derived from samples with high SDF (Sperm DNA Fragmentation) index, develop into embryos of poor quality that lead consequently to lower implantation and pregnancy rates and higher miscarriage rates, in intracytoplasmic sperm injection cycles from women with advanced maternal age.
The results of this study are of great significance to clinical work:
Women’s age cannot be changed, but male SDF can be improved through diet, environment, lifestyle changes, antioxidant and other therapies.
This study may provide new ideas for improving the ART pregnancy rate of elderly couples and reducing the abortion rate.
Reference:
Oocyte ability to repair sperm DNA fragmentation: the impact of maternal age on intracytoplasmic sperm injection outcomes
Fertility and Sterility (IF7.329), Pub Date : 2021-02-13, DOI: 10.1016/j.fertnstert.2020.10.045
Amanda Souza Setti, Daniela Paes de Almeida Ferreira Braga, Rodrigo Rosa Provenza, Assumpto Iaconelli, Edson Borges
Is maternal caffeine intake associated with neonatal anthropometry?
Findings
In this cohort study of 2055 women from 12 clinical sites, measures of caffeine consumption (plasma caffeine and paraxanthine and self-reported consumption) were associated with neonatal size at birth.
Increasing caffeine measures were significantly associated with lower birth weight, shorter length, and smaller head, arm, and thigh circumference.
A study has found that caffeine consumption during pregnancy, even in amounts less than the recommended 200 mg per day, is linked to smaller neonatal anthropometric measurements.
The longitudinal cohort study in JAMA Network Open concluded that compared to women who drank no, or very little caffeine, women who drank the most caffeine (a plasma caffeine level of ≤ 28 ng/mL) had neonates who weighed 84 g less, were 0.44 cm shorter in length, a 0.28 cm smaller head circumference, a 0.25 cm smaller arm circumference, and a 0.29 cm smaller thigh circumference.
“Most of the research on caffeine and neonatal size at birth focuses on birthweight and length, while relying on self-reported measures of caffeine consumption.,” said senior author Katherine Grantz, MD, an investigator in the Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, in Bethesda, Maryland.
The current study analyzed data from the NICHD Fetal Growth Studies–Singletons, which enrolled 2,055 nonsmoking women at low risk for fetal growth abnormalities with complete information on caffeine consumption from 12 U.S. clinical sites between 2009 and 2013.
“In the NICHD Fetal Growth Studies, we have rich data on multiple measures of neonatal anthropometry to more specifically characterize neonatal size, as well as objective measures of plasma concentrations of caffeine and its primary metabolite, paraxanthine,” Grantz told Contemporary OB/GYN.
The two main sources of caffeine were coffee and soda, which accounted for 35% and 41% of caffeine intake, respectively.
Caffeine was evaluated by both plasma concentrations of caffeine and paraxanthine and self-reported caffeinated beverage consumption measured/reported at 10 to 13 weeks gestation.
Caffeine metabolism was defined as fast or slow, based on genotype information from the single nucleotide variant rs762551.
“Prior caffeine studies have observed lower birthweight after consumption of higher amounts of caffeine — usually 200 to 300 mg, or 2 to 3 cups of coffee, daily,” said Grantz, who served as a co-principal investigator of the NICHD Fetal Growth Studies.
Before starting their analyses, the current authors knew that the average consumption in the sample was much lower, about 35 mg/day, and only 16 women reported drinking more than 200 mg/day.
Because of this low consumption, we were uncertain we would see any significant results, so it was surprising that we still found that increasing caffeine consumption, even at low levels, was associated with some smaller anthropometric measures in the offspring,” Grantz said. “Also, the finding that the decreases in birthweight were manifested by decreases in bone and muscle measures, but not skin folds and fat mass, were unexpected. These findings may indicate decreases in lean tissue as caffeine consumption increases.”
The clinical implications of the study are unknown, considering there were only small reductions in some neonatal anthropometric measures, Grantz said. “Other evidence suggests that even small amounts of caffeine intake during pregnancy (50 mg/day) could be associated with a higher risk of excess growth in infancy and childhood that could put children at higher risk of later cardiometabolic disease,” she said.
“Therefore, our results could indicate some disruption in normal fetal growth patterns, but will require more research to confirm.”
Although the study authors are unable to make recommendations based on the results of their single study, “we encourage pregnant women to talk to their providers about caffeine consumption, and suggest that caution may be warranted,” Grantz said.
The next step for the investigators is to evaluate the serial ultrasounds and fetal volumes conducted throughout pregnancy by the NICHD Fetal Growth Studies to determine when changes begin in fetal growth in relation to caffeine measures, and how these changes may be manifested in fetal volumes.
Disclosure
Grantz reports no relevant financial disclosures.
Reference
Gleason JL, Tekola-Ayele F, Sundaram R, et al. Association between maternal caffeine consumption and metabolism and neonatal anthropometry: a secondary analysis of the NICHD Fetal Growth Studies–Singletons. JAMA Network Open. Published online March 25, 2021. doi:10.1001/jamanetworkopen.2021.3238
broccoli is the star but eating plenty of green vegetables of the cruciferous family help the liver metabolise oestrogen.
Other cruciferous vegetables include: Bok-Choy, Brussels sprouts, Cabbage, Cauliflower, Chinese cabbage, Daikon radish, Horseradish, Kale, Radish, Turnip and Watercress.
Eat high fibre foods to help oestrogen bind in the bowel and assist elimination.
One source suggests that eating 1/2 cup of raw grated carrots can be enough fibre to assist in elimination
Decrease alcohol consumption
Assist the liver by drinking St Mary’s Thistle and Dandelion tea
Avoid soy
Eat a no sugar and no gluten diet
sugar and gluten are both highly inflammatory in susceptible people so should be avoided when possible
Be mindful of too many vitamins, supplements, medications and even caffeine that all need to be processed by the liver, where possible space them out through the day.
Chinese herbal medicine
Some Chinese herbal medicine /formula may help assist in balance your hormone. You may contact us for details.
Natural Ways to Increase Progesterone
Reduce stress
google progesterone steal if you are more interested in how stress affects progesterone levels
Supplements:
750 mg vitamin C per day (increased progesterone 77% and improved fertility)
600 mg vitamin E (increased progesterone in 67% of patients)
6 g L-arginine (increased progesterone in 71% of patients)
Increasing beta carotene in your diet, as found in:
Apricots, Asparagus, Broccoli, Carrots, Chinese cabbage, Chives, Dandelion leaves, Grapefruit, Herbs and spices – chilli powder, oregano, paprika, parsley, Kale, Onions, Peas, Peppers, Plums, Pumpkin, Spinach, Squash, Sweet potatoes. So again, get onto those carrots!
Supplementing with
Vitex Agnus Castus 1000mg daily
Black Cohosh or as we call it in Chinese Medicine ‘Sheng ma’ on days 1 to 12 (increases progesterone and fertility).
Weight loss
Improving insulin sensitivity (for example metformin increases progesterone levels 246%, chromium supplementation can help in regulating blood sugar in combination with a low sugar and low carbohydrate diet)
Replacing saturated fat in the diet with unsaturated fat
Eating a high protein, low carbohydrate diet
Lowering TSH levels in subclinical hypothyroidism
Chinese herbal medicine
Some Chinese herbal medicine /formula may help assist in balance your hormone. Contact us for details.
Iron plays a crucial role in fetal development. It supporting blood, brain, and bone formation, as well as overall growth. It’s also vital for a healthy immune system and fertility. Low iron levels can lead to anovulation, hindering fertility. In a Harvard University study of 18,500 women, those supplementing iron were 40% less likely to have fertility problems.
During pregnancy, iron requirements increase due to greater blood volume. It’s essential to boost iron intake in the 2nd and 3rd trimesters as the fetus relies on maternal iron stores. Deficiency raises the risk of anemia, preterm delivery, and low birth weight.
Women with low iron are advised to supplement 10-20mcg daily. Liquid supplements are gentler on the stomach. Organic iron supplements are preferable as they’re better absorbed. Vitamin C aids iron absorption.
Natural sources of iron
Natural sources include green leafy vegetables, dried beans, black strap molasses, lean meat (organic/chemical free), dried apricots, almonds, egg yolk, seaweed, wheat germ, parsley, pumpkin, sesame and sunflower seeds.
Folic acid (B9) and B vitamins
Folic acid (B9) and B vitamins are essential for DNA formation, crucial for preconception and early pregnancy. Supplementation is recommended, especially for women on birth control pills. Deficiency can lead to infertility and birth defects.
Natural sources of B9
Natural sources include dark green leafy vegetables, i.e., uncooked spinach, kale, beet greens; asparagus, broccoli, corn, lima beans, parsnip, mung beans, soy beans; wheat germ; oranges, pineapple, banana. It’s best to consume these foods fresh and raw to preserve B9, as it’s heat-sensitive.
Vitamin D – The sunshine vitamin
Vitamin D, known as the sunshine vitamin, is crucial for fertility. Testing vitamin D levels is recommended, as deficiency is common, affecting 23-49% of Australians. Supplements are advised for levels under 50.
Omega 3 fatty acids
Omega-3 fatty acids are essential for hormonal balance, ovulation, and fetal development, supporting both fertility and healthy pregnancies. In a study, couples receiving 1000mg of omega-3 had a fertilization rate of 76.5%, significantly higher than the 50.4% rate in those without omega-3.
During pregnancy, a deficiency in DHA, a type of omega-3, may lead to various complications, including premature birth, low birth weight, chromosomal defects, spontaneous abortion, hyperactivity, and childhood asthma. We recommend 500-1000mg of DHA daily to support a healthy pregnancy.
Natural Sources of Opmega 3
Natural Sources include deep sea ocean/cold water fish (ie. salmon, cod, herring, trout), mono-unsaturated cold-pressed oils (flaxseed especially, walnuts, hemp and chia seeds.
Vitamin E
Vitamin E supports conception, regulates estrogen levels, and aids circulation. Deficiency can lead to complications like spontaneous abortion.
Natural Sources
Sources include sunflower seeds, almonds, organic cold-pressed wheat germ oil, cold-pressed vegetable, seed and nut oils. Best not heated or cooked, i.e., use in salad dressing.
Protein/Amino Acids
Vital for the number and quality of the ovum (eggs) produced the fertilisation process, and the early development of the embryo.
Natural sources
include deep sea fish, tofu, legumes ie. lentils, soy beans, kidney beans, eggs (free range), lean organic chemical-free meat and poultry, nuts and seeds, sprouted grains.
Calcium
Calcium is essential for fetal bone development, nerve function, and muscle tone. Deficiency can lead to complications like hypertension and bone loss.
Natural Sources
Natural sources include leafy greens, nuts, and seeds.
Dairy foods are another source of calcium; however, since they are not as easily absorbed, it is best to vary your sources of calcium as widely as possible.
Royal jelly
Royal jelly is rich in amino acids, vitamins, and minerals, beneficial for hormone balance and reproductive health. Some evidence exists that royal jelly might also:
Improve egg and sperm health
Increase libido
Reduce inflammation
Support the immune system
Decrease signs of aging
Helps women with irregular cycles
PLEASE DO NOT TAKE IF ASTHMATIC OR ALLERGIES TO BEE’S
Co Q10
CoQ10 supports energy production and cellular health. Supplementation may enhance egg quality and IVF success rates.
Managing PCOS
Chromium and magnesium supplementation, along with a low-GI diet, can help manage PCOS symptoms and improve glycemic control.
Question
Iron