Menstrual Changes After Abortion: What to Expect

Menstruation after abortion?

Hello doctor, I had a surgical abortion last month (around 5 weeks).
This week, my period started and the flow is a bit heavier than usual, with quite a few blood clots.
I passed a large clot the last time I went to the bathroom, and I haven't had this many clots before.
Is this normal? If I need to see a doctor, should I wait until after my period ends?

S, 20~29 year old female. Ask Date: 2018/05/24

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Last month, I had an abortion (about 5 weeks), and this week my period started with a heavier flow and blood clots.
There are quite a few clots, with a large one appearing the last time I went to the bathroom.
I didn't have this many clots before.
Is this normal? Should I see a doctor after my period ends? Answer: Having blood clots like this is common, and there is no need to see a doctor at this time.

Reply Date: 2018/05/24

More Info

After undergoing an abortion, it is common for women to experience changes in their menstrual cycle, including variations in flow, the presence of blood clots, and changes in the timing of their next period. These changes can be attributed to several factors, including hormonal adjustments, the body's healing process, and the physical effects of the procedure itself.

In your case, experiencing a heavier menstrual flow with blood clots after an abortion is not unusual. It is important to understand that the body may take some time to return to its normal menstrual pattern following the termination of a pregnancy. The presence of blood clots can occur as the uterus sheds its lining, which may be thicker than usual due to the hormonal changes associated with pregnancy. Blood clots can vary in size, and while small clots are generally considered normal, larger clots (such as the one you described) can sometimes be concerning.

Typically, after an abortion, the first menstrual period may be heavier and more painful than usual. This is due to the uterus contracting to expel any remaining tissue and the thickened endometrial lining. However, if you notice an excessive amount of bleeding (soaking through a pad in an hour or less), severe pain that is not relieved by over-the-counter pain medication, or if you have any signs of infection (such as fever, chills, or foul-smelling discharge), it is crucial to seek medical attention promptly.

Regarding your question about when to see a doctor, it is advisable to monitor your symptoms closely. If the heavy bleeding and presence of large clots persist beyond a few days or worsen, you should contact your healthcare provider sooner rather than later. If you are experiencing significant discomfort or any concerning symptoms, do not wait until your period ends to seek medical advice.

In summary, while changes in menstrual flow and the presence of blood clots can be normal after an abortion, it is essential to remain vigilant about your symptoms. If you have any doubts or if your symptoms are severe, do not hesitate to reach out to your healthcare provider for guidance. They can perform an examination and possibly an ultrasound to ensure that your uterus is healing properly and that there are no complications. Your health and well-being are paramount, and it is always better to err on the side of caution when it comes to your reproductive health.

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