Post-Medication Abortion: Managing Uterine Contraction Medication

Issues Regarding the Use of Uterine Contraction Medication After Medical Abortion

Hello Dr.
Huang: My menstrual cycle has been regular before the medication abortion.
On August 22, I took RU486, and after receiving an intravenous infusion on August 23, I started to bleed.
I followed the instructions and took the medication at home.
During my follow-up appointment on August 26, I was informed that I had expelled some tissue but still had some retained products of conception, so I was advised to take uterotonics and a herbal concoction.
On September 2, during my follow-up visit, a urine test still showed a positive result, but I had stopped bleeding.
The doctor prescribed a three-day course of uterotonics for me to take when my next menstrual period arrives, which the doctor estimated might be on September 23.
I have also stopped taking the herbal concoction on my own.

From September 2 to September 6, I noticed no blood when wiping in the morning, but in the afternoon, I started to see some blood, although it was minimal.
Due to the presence of blood, I suspected that my uterus might be starting to expel retained products again, so I took the uterotonics immediately and took another dose after dinner.
Currently, the amount of bleeding resembles that of days three and four of a typical menstrual period.
I did not follow the instructions to wait for my next period to take the uterotonics.

1.
Should I not have taken the uterotonics?
2.
Now that I have taken them, will it affect the estimated date of my next period?
3.
Do you recommend continuing the uterotonics?
4.
Is it necessary to continue taking the herbal concoction?
5.
I am currently avoiding cold and fried foods and am not consuming any food supplements related to recovery.
If I need to wait until my next period ends to ensure that everything is completely expelled before consuming any supplements related to miscarriage recovery, will that be too late in terms of timing?

Miss Lin, 20~29 year old female. Ask Date: 2017/09/07

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Before the medical abortion, my menstrual cycle was regular every month.
On August 22, I took RU486, and after receiving an IV on August 23, I started to experience bleeding.
I followed the instructions and took the medication at home.
During my follow-up appointment on August 26, I was informed that I had expelled some tissue but there was still some retained.
I was instructed to take uterotonics and a herbal remedy.
On September 2, during my follow-up visit, a urine test still showed a positive result, but I had stopped bleeding.
The doctor prescribed a three-day supply of uterotonics and advised me to take them when my next menstrual period arrives, which the doctor estimated might be on September 23.
I also stopped taking the herbal remedy on my own.
From September 2 to September 6, in the mornings, there was no blood when I wiped after using the restroom, but in the afternoons, I began to notice some blood, although it was minimal.
Due to the presence of blood, I thought my uterus might be starting to expel retained material again, so I took the uterotonics immediately and took another dose after dinner.
Currently, the bleeding is similar to what I would experience on the third or fourth day of my usual period.
I did not follow the instructions to wait until my next period to take the uterotonics.
1.
Should I not have taken the uterotonics?
Answer: You can take the uterotonics.
2.
Now that I have taken them, will it affect the estimated date of my next period?
Answer: It will not affect the estimated date of your next period.
3.
Should I continue taking the uterotonics?
Answer: Given that the bleeding is similar to what you would experience on the third or fourth day of your usual period, it is not recommended to continue taking the uterotonics.
4.
Is there a need to continue taking the herbal remedy?
Answer: There is no need to continue taking the herbal remedy.
5.
I am currently avoiding cold and fried foods and following dietary recommendations to avoid any food-related tonics.
If I wait until my next period ends to ensure everything is completely expelled before consuming supplements related to miscarriage, will that be too late in terms of timing?
Answer: In terms of timing, it will not be too late.

Reply Date: 2017/09/07

More Info

Post-medication abortion, particularly using medications like RU486 (mifepristone) and misoprostol, can lead to a variety of physiological responses, including uterine contractions and bleeding. It’s important to manage these symptoms carefully to ensure both physical and emotional well-being.

1. Use of Uterine Contraction Medication: It seems you have taken uterine contraction medication (likely misoprostol) after your abortion procedure. While these medications are intended to help expel any remaining tissue, they should be used according to your physician's instructions. If your doctor advised you to wait until your next menstrual period to take the medication, it is generally best to follow that guidance. Taking it prematurely, especially if you are already experiencing bleeding, could lead to excessive uterine contractions and increased discomfort.

2. Impact on Menstrual Cycle: Taking uterine contraction medication outside of the prescribed timeline may affect your next menstrual cycle. The hormonal balance in your body can be disrupted, potentially leading to irregularities in your cycle. It’s essential to monitor your body’s responses and report any significant changes to your healthcare provider.

3. Continuing Uterine Contraction Medication: If you have already taken the medication, it’s crucial to assess how your body is responding. If you are experiencing heavy bleeding or severe pain, you should contact your healthcare provider immediately. They may recommend stopping the medication or adjusting your treatment plan based on your symptoms.

4. Herbal Remedies (生化湯): The use of herbal remedies like 生化湯 (a traditional Chinese medicine often used post-abortion) should also be approached with caution. If your doctor has not specifically advised you to continue taking it, and considering that you are experiencing some bleeding, it might be wise to pause its use until you have a clearer understanding of your body’s recovery. Herbal remedies can interact with medications and may not be suitable during certain phases of recovery.

5. Timing for Nutritional Supplements: Regarding the timing of when to start taking supplements for recovery after a miscarriage or abortion, it is generally advisable to wait until you have confirmed that your uterus is clear of any remaining tissue. This is to avoid any complications that could arise from introducing supplements while your body is still in a state of recovery. While it may feel like a delay, ensuring that your body is ready for additional support is crucial for your overall health.

In summary, it is essential to follow your healthcare provider's instructions closely regarding the use of uterine contraction medications and any additional treatments. If you have concerns or experience unusual symptoms, do not hesitate to reach out to your healthcare provider for guidance. They can provide personalized advice based on your specific situation and help ensure that your recovery is as smooth as possible. Remember, your health and well-being are the top priority during this time.

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