Symptoms After Taking RU486: What to Expect and When to Seek Help

Symptoms after taking RU486?

Hello, I would like to ask about my situation.
I took RU486 for an abortion on May 28 when I was already 6 weeks along.
I took the second dose on May 30.
I had my first follow-up ultrasound on June 2, and the doctor said that the embryo was not visible and that everything was cleared out.
However, my bleeding has not been heavy; I have been experiencing only light bleeding.
I had another follow-up appointment on June 17, and the doctor again confirmed via ultrasound that everything was clear.
When I asked why I was still bleeding, the doctor mentioned that it might be due to slow uterine contractions and prescribed a 3-day course of uterine contraction medication.
I was advised to wait until the end of June to see if my menstrual period would come and then reassess.

On June 3, I experienced bleeding similar to what I would expect before my period, but after a week, I found it strange that I was still having light bleeding even though my period should have started.
So, on July 15, I returned for another check-up.
The doctor again confirmed via ultrasound that there was nothing in the uterus, but I was still experiencing light bleeding.
I was prescribed another 3-day course of uterine contraction medication and instructed to have a full bladder for the next ultrasound.

Actually, after picking up the medication on June 15, I did not see any bleeding on June 16 and 17, and I thought everything was fine.
However, on the afternoon of June 17, I noticed the bleeding had resumed.
On June 19, I went for the ultrasound with a full bladder.
The doctor did not say much; when I asked if anything was visible, he mentioned that my abdomen appeared "cloudy" and that nothing could be seen.
A urine test was done, and I was not pregnant.

I have been experiencing this light bleeding for almost two months now.
What could be the problem? Should I go to a larger hospital for further examinations? Should I still see an obstetrician-gynecologist?

Jinjin, 30~39 year old female. Ask Date: 2016/07/20

Dr. Lü Lizheng reply Obstetrics and Gynecology

The response indicates that most of the tissue has likely been expelled, so the ultrasound appears to be clear.
However, there may still be a small amount of embryonic cells remaining, but it is minimal and not easily detectable on the ultrasound.
Therefore, it is advisable to be patient, as it should eventually be expelled completely.
Taking uterine contraction medication may expedite the process.
In very rare cases, there could be an ectopic pregnancy; however, doctors typically confirm that the pregnancy is intrauterine before administering RU486, so the likelihood is low.
Best regards, Dr.
Lu Li-Cheng, Taoyuan Hospital.

Reply Date: 2016/07/20

More Info

It sounds like you've been through a challenging experience after taking RU486 for a medical abortion, and I can understand your concerns regarding the ongoing bleeding and the lack of clear answers from your healthcare providers. Let's break down what you might expect after taking RU486, what could be causing your symptoms, and when it might be appropriate to seek further medical help.

RU486, also known as mifepristone, is used in combination with misoprostol to terminate a pregnancy. After taking these medications, it is common for women to experience bleeding, which can vary in amount and duration. Typically, the bleeding should resemble a heavy menstrual period and may last for several days to a few weeks. However, some women may experience prolonged bleeding, which can be concerning.

From your description, it seems that you have been experiencing light bleeding for an extended period, which can occur due to several reasons:
1. Incomplete Abortion: Sometimes, the medications may not completely expel all pregnancy tissue, leading to ongoing bleeding. This is often assessed through follow-up ultrasounds, which you have undergone.

2. Uterine Contraction Issues: As your doctor mentioned, slow uterine contractions can lead to prolonged bleeding. The medications prescribed to help with uterine contractions are intended to address this issue.

3. Hormonal Fluctuations: After an abortion, your body undergoes hormonal changes that can affect your menstrual cycle and bleeding patterns. It may take some time for your body to return to its normal cycle.

4. Other Medical Conditions: Conditions such as fibroids, polyps, or infections can also cause abnormal bleeding.
Given that you have been experiencing bleeding for nearly two months and have had multiple ultrasounds that did not reveal any retained tissue, it would be prudent to seek further evaluation. Here are some steps you can consider:
- Consult a Specialist: If you haven't already, consider seeing a gynecologist or a reproductive health specialist. They may have more experience with post-abortion complications and can provide a thorough evaluation.

- Further Testing: Depending on your symptoms and the findings from your ultrasounds, your doctor may recommend additional tests, such as a hysteroscopy (a procedure to look inside the uterus) or blood tests to check for any underlying issues.

- Monitor Symptoms: Keep track of your bleeding patterns, any pain, or other symptoms you may experience. If you notice an increase in bleeding, passing large clots, or severe pain, seek immediate medical attention.

- Discuss Concerns: Don’t hesitate to express your concerns to your healthcare provider. It’s important that you feel heard and that your symptoms are taken seriously.

In summary, while some bleeding after taking RU486 can be normal, prolonged bleeding warrants further investigation. Seeking care from a specialist may provide you with the answers and reassurance you need. Remember, your health and well-being are paramount, and it’s essential to advocate for yourself in the healthcare system.

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