Post-Abortion Bleeding: Causes and Concerns

Post-abortion bleeding

Hello Doctor, two years ago I underwent a medication-induced abortion at a large hospital due to certain factors, and I had follow-up appointments where the doctor confirmed that everything was clear.
Therefore, I did not return for further check-ups.
However, since then, my menstrual cycle has been irregular.
About a week after my period ends, I experience some brown discharge mixed with cervical mucus, which, upon closer inspection, appears to have blood streaks.
I also occasionally have mild, unilateral abdominal discomfort, but it does not occur every month and lasts for a few days before subsiding until my next period.
Could you please tell me what this condition might be? I am quite worried.
Thank you.

Hai Shan, 20~29 year old female. Ask Date: 2017/08/03

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Two years ago, I underwent a medical abortion at a large hospital, and I had follow-up appointments where the doctor confirmed that everything was cleared out.
After that, I did not return for further check-ups.
However, since then, my menstrual cycle has been irregular.
About a week after my period ends, I experience some brown discharge mixed with cervical mucus, which, upon closer inspection, appears to have blood streaks.
I also occasionally have mild, unilateral abdominal discomfort, but this does not occur every month and lasts for a few days before resolving until my next period.
Could you please tell me what condition this might indicate?
Answer: The irregular menstrual cycles, brown discharge mixed with cervical mucus, and mild unilateral abdominal discomfort suggest that you may need to undergo an ultrasound examination or possibly a hysteroscopy for further evaluation.

Reply Date: 2017/08/03

More Info

Post-abortion bleeding and irregular menstrual cycles can be concerning for many women, especially after experiencing a significant event like an abortion. Your symptoms, including the presence of brown discharge with blood-tinged mucus and unilateral abdominal discomfort, warrant a thorough understanding of potential causes and implications.

Firstly, it’s important to recognize that after an abortion, whether medical or surgical, the body undergoes a period of adjustment. This includes the shedding of the uterine lining, which can sometimes lead to irregular bleeding patterns. The brown discharge you are experiencing is likely old blood that is being expelled from the uterus, which is not uncommon. This can happen for several weeks post-abortion as the body works to return to its normal menstrual cycle.

The irregularities in your menstrual cycle following the abortion could be attributed to several factors:
1. Hormonal Imbalance: After an abortion, hormonal levels can take time to stabilize. The hormones that regulate your menstrual cycle, such as estrogen and progesterone, may be out of sync, leading to irregular periods. This can manifest as delayed menstruation, spotting between periods, or changes in flow.

2. Uterine Healing: The uterus needs time to heal after an abortion. If there were any retained products of conception, this could lead to prolonged bleeding or spotting. Although your doctor indicated that everything was cleared, it’s still possible for small remnants to cause ongoing issues.

3. Ovulation Issues: Irregular cycles can also be a sign of anovulation, where the ovaries do not release an egg. This can lead to missed periods or unexpected bleeding.

4. Pelvic Inflammatory Disease (PID): If there was any infection during or after the abortion, it could lead to PID, which can cause irregular bleeding and abdominal pain. Symptoms of PID can include fever, unusual discharge, and pain during intercourse.

5. Endometriosis or Other Conditions: The unilateral abdominal pain you mentioned could also suggest conditions like endometriosis or ovarian cysts, which can cause similar symptoms and may require further investigation.

Given your concerns, it’s advisable to consult with a healthcare provider for a comprehensive evaluation. They may recommend:
- Pelvic Ultrasound: To check for any retained tissue, cysts, or other abnormalities in the reproductive organs.

- Hormonal Testing: To assess your hormone levels and determine if there is an imbalance that needs to be addressed.

- Infection Screening: To rule out any infections that could be contributing to your symptoms.

In terms of your worry about future fertility, it’s important to note that while complications can arise from an abortion, many women go on to have healthy pregnancies afterward. However, persistent irregularities in your menstrual cycle should be addressed to ensure there are no underlying issues that could affect your reproductive health.

In conclusion, while some irregularities post-abortion can be normal, your symptoms suggest that further evaluation is warranted. It’s essential to communicate openly with your healthcare provider about your concerns and symptoms to receive appropriate care and guidance. Remember, your health and peace of mind are paramount, and seeking medical advice is a proactive step toward understanding and addressing your situation.

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