Brown Discharge After Medication Abortion: What to Expect

Post-medication abortion coffee-colored discharge?

Hello Doctor: My girlfriend took RU486 and uterine contraction medication on 11/17 and 11/19.
She had a follow-up appointment on 11/20, and the doctor said the embryo was expelled completely.
During her next follow-up on 12/3, the doctor said everything was okay.
However, I am still experiencing brown discharge.
Is this normal, or could it indicate incomplete expulsion? The brown discharge is manageable with a panty liner.
When can I expect her menstrual period to return? What is the latest date she should see a doctor if her period does not arrive? Is this a sign of poor uterine contractions, or could it be related to the medication? If she needs to have her HCG levels checked, when would be the best time for that? Can discharge be tested as well? If her next period arrives, will taking emergency contraception harm her uterus? Or should she wait until after her next cycle to take it, as I am concerned about potential infertility in the future? Thank you for your patience!

Fang, 20~29 year old female. Ask Date: 2018/12/04

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, after a medical abortion, if there are coffee-colored discharge, it may indicate that the uterus has not completely cleared.
It is advisable to return to your original obstetrician-gynecologist for an examination.
Wishing you good health.

Reply Date: 2018/12/04

More Info

After a medication abortion, it is common to experience some brown discharge, which can be concerning for many individuals. The brown color typically indicates older blood that has taken longer to exit the uterus, and it is often a normal part of the recovery process. In your case, since your girlfriend had a medication abortion on November 17 and 19, and the doctor confirmed that the pregnancy tissue was expelled on November 20, the ongoing brown discharge could be a normal residual effect.
It is essential to understand that after a medication abortion, the body goes through a process of healing and clearing out the uterine lining. This can take some time, and brown discharge can persist for several weeks. If the discharge is not accompanied by severe pain, heavy bleeding, or foul odor, it is generally not a cause for concern. However, if the discharge continues for an extended period or if there are any alarming symptoms, it would be wise to consult a healthcare provider to rule out any complications, such as retained products of conception.

Regarding the return of menstruation, it can vary significantly among individuals. Many women may experience their first period within four to six weeks after the abortion, but it can take longer for some. If your girlfriend does not get her period within eight weeks, it would be advisable for her to see a healthcare provider. This visit can help assess whether her body is returning to its normal cycle and whether any further evaluation, such as an HCG (human chorionic gonadotropin) test, is necessary.

As for the HCG test, it is typically performed to ensure that the pregnancy hormone levels have returned to zero after an abortion. This test can be done a few weeks after the procedure, and it is not necessary to wait for the discharge to stop. If there are concerns about the discharge or if it seems excessive, it may be beneficial to discuss this with a healthcare provider, who can provide guidance on whether an HCG test is appropriate at that time.

When it comes to starting hormonal birth control after an abortion, it is generally safe to begin taking contraceptives once the body has had a chance to recover. Many healthcare providers recommend starting birth control immediately after an abortion to prevent unintended pregnancies. However, it is essential to discuss this with a healthcare provider to ensure that it is the right choice for your girlfriend's specific situation.
In summary, brown discharge after a medication abortion can be normal, and the return of menstruation can vary. If there are any concerns about the discharge or if menstruation does not resume within a reasonable timeframe, it is best to consult a healthcare provider. Starting birth control after the abortion is typically safe, but it is advisable to have a discussion with a healthcare provider to address any concerns and ensure the best approach for future reproductive health.

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