Post-Abortion Bleeding: Causes and Treatment Options

Postpartum bleeding for over a month?

Hello Doctor, I received my first dose on November 1st and my second dose on November 3rd.
I continued to experience bleeding until the end of the month, so I had a follow-up appointment and was prescribed some medication, but the bleeding did not stop.
I went for another check-up and was given more medication.
Eventually, I had one day without bleeding, but the next day I experienced heavy bleeding again.
I switched to another obstetrician-gynecologist, who said that everything was clear, and prescribed me oral contraceptives to take for a month.
Is it safe for me to take them? Could this be due to irregular menstruation, or is there something else going on? Thank you.

@, 20~29 year old female. Ask Date: 2017/12/08

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I received my first dose on November 1st and my second dose on November 3rd.
I continued to experience bleeding until the end of the month, so I went for a follow-up appointment and was prescribed some medication, but the bleeding did not stop.
I went for another check-up and received more medication.
Eventually, the bleeding stopped for one day, but then it started again heavily.
I switched to a different obstetrician-gynecologist, who said that everything had cleared out.
Therefore, they prescribed me oral contraceptives and advised me to take them for a month.
Is it safe for me to take them? Could this be due to irregular menstruation, or is there something else going on? The doctor said everything had cleared out, so it is okay to take the oral contraceptives for a month.

Reply Date: 2017/12/08

More Info

Post-abortion bleeding is a common concern for many women who have undergone a medical or surgical abortion. Understanding the causes and treatment options for this condition is crucial for ensuring proper recovery and addressing any potential complications.

Causes of Post-Abortion Bleeding
1. Incomplete Abortion: One of the most common reasons for prolonged bleeding after an abortion is an incomplete abortion, where some tissue remains in the uterus. This can lead to ongoing bleeding and may require further medical intervention, such as a dilation and curettage (D&C) procedure to remove any retained products of conception.

2. Hormonal Changes: After an abortion, the body undergoes significant hormonal changes as it returns to its pre-pregnancy state. These fluctuations can lead to irregular bleeding patterns, including prolonged bleeding or spotting.

3. Infection: In some cases, post-abortion bleeding can be a sign of infection in the uterus. Symptoms of infection may include fever, foul-smelling discharge, and severe abdominal pain. If an infection is suspected, prompt medical treatment is necessary.

4. Uterine Atony: This condition occurs when the uterus does not contract effectively after the abortion, leading to excessive bleeding. Uterine atony can be managed with medications that promote uterine contraction.

5. Other Factors: Other factors that may contribute to prolonged bleeding include the use of certain medications, underlying health conditions, or complications during the abortion procedure.

Treatment Options
1. Monitoring: If the bleeding is not excessive and there are no signs of infection or other complications, your healthcare provider may recommend monitoring the situation. It is essential to keep track of the amount and duration of bleeding.

2. Medications: Your doctor may prescribe medications to help manage bleeding. This can include hormonal treatments, such as birth control pills, which can help regulate your menstrual cycle and reduce bleeding.

3. Dilation and Curettage (D&C): If there is evidence of retained tissue or if bleeding is excessive, a D&C may be necessary. This procedure involves the gentle scraping of the uterine lining to remove any remaining tissue.

4. Antibiotics: If an infection is suspected, your doctor may prescribe antibiotics to treat the infection and prevent further complications.

5. Follow-Up Care: Regular follow-up appointments are crucial to monitor your recovery. If bleeding persists or worsens, further evaluation may be necessary.

Considerations for Birth Control
Regarding the use of birth control pills after your abortion, it is generally safe to start hormonal contraception as recommended by your healthcare provider. Birth control pills can help regulate your menstrual cycle and may reduce the risk of heavy bleeding. However, it is essential to discuss any concerns you have with your doctor, especially if you are experiencing irregular bleeding.

Conclusion
In summary, post-abortion bleeding can be caused by various factors, including incomplete abortion, hormonal changes, and infections. Treatment options range from monitoring and medication to surgical intervention if necessary. It is crucial to maintain open communication with your healthcare provider and attend follow-up appointments to ensure a smooth recovery. If you have any concerns about your bleeding or the use of birth control, do not hesitate to reach out to your doctor for personalized advice and support.

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