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lower right side back pain nd spotting two days a week nd pain during sex
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bivens83 posted:
lower right side back pain and spotting two days this week when i had a period two weeks ago and pain after sex
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Jane Harrison Hohner, RN, RNP responded:
Dear bivens: If you happen to be on some kind of hormonal birth control (pill/patch/ring/Mirena) the most likely explanation would be "normal" breakthrough bleeding/spotting due to the hormones in the birth control. Yet this would not prompt pain radiating to the back. If you are not using hormones then the following is my best GUESS.

You mentioned that the spotting began about cycle day 14 (cycle day 1 being the first day of your last period). Given this specific timing the most likely cause would be bleeding with ovulation. Right before ovulation there is a brief spike of estrogen. When this level drops back down to normal, the sharp decline can destabilize the lining of the uterus leading to spotting/bleeding. Some women have this sign of ovulation every month; others only rarely. Fortunately the amount is usually scant and brief in duration.

Some other possible causes of erratic spotting can include a new chlamydia infection (unlikely if you are both monogamous). polyps of the lining of the uterus (way more common in midlife women), or missed/erratic ovuations (usually there will be a history of missed/irregular periods). One possible cause of a missed ovulation would be a large ovarian cyst. A large ovarian cyst can prompt both generalized pelvic pain and worsened pain with sex.

If your erratic bleeding and/ or pain persists, see your GYN or local family planning clinic. You deserve a more "for sure" answer. Hopefully, since it never happened before, this is an isolated episode of ovulation-linked spotting or a temporary ovarian cyst.

Yours,
Jane


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