Bleeding Duration After RU486: What to Expect - Obstetrics and Gynecology

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After taking RU486, also known as mifepristone, it is common to experience a range of bleeding patterns as the body undergoes changes following a medical abortion. The duration and nature of bleeding can vary significantly from person to person, and understanding what to expect can help alleviate some anxiety.

1. Bleeding Duration and Patterns: Generally, after taking RU486, bleeding typically begins within a few days and can last anywhere from a few days to several weeks. The initial bleeding may be heavy, resembling a menstrual period, and can include blood clots. It's not unusual for the bleeding to fluctuate in intensity, with some individuals experiencing a sudden increase in bleeding after a period of lighter flow. In your case, bleeding for 13 days with a sudden increase in volume and the presence of clots is concerning but not uncommon.

2. Factors Influencing Bleeding: The increase in bleeding you are experiencing could be influenced by several factors, including the body's hormonal response to the medication, the presence of retained tissue, or the effects of any additional medications you are taking, such as the herbal remedies. The use of Tranexamic acid (the hemostatic agent prescribed) is intended to help control excessive bleeding, but it may not completely eliminate the risk of heavy bleeding if there are underlying issues.

3. Herbal Remedies: It’s important to note that while some herbal remedies are used to promote healing and regulate menstrual cycles, they can also have varying effects on bleeding. The use of "活血化瘀" (herbs that invigorate blood circulation) may not be advisable immediately after taking RU486, as they could potentially exacerbate bleeding. Always consult with your healthcare provider before combining herbal treatments with prescribed medications.

4. When to Seek Medical Attention: If you notice a significant increase in bleeding, especially if you are soaking through pads in an hour or less, or if you experience severe abdominal pain, it is crucial to seek medical attention. These could be signs of complications such as retained products of conception or an incomplete abortion.

5. Psychological Factors: Anxiety and stress can also manifest physically, leading to symptoms such as abdominal pain. It’s essential to address both physical and emotional health during this time. Consider discussing your feelings with a healthcare provider or a mental health professional if you feel overwhelmed.

6. Normal Bleeding Duration: On average, bleeding after a medical abortion can last from a few days up to four weeks. If bleeding continues beyond this period or if you have concerns about the nature of the bleeding, follow up with your healthcare provider for further evaluation.

7. Dietary Considerations: While you mentioned avoiding cold foods and sesame oil, it’s generally advisable to maintain a balanced diet rich in iron and vitamins to support recovery. If you have specific dietary restrictions or concerns, discussing these with a healthcare provider or a nutritionist can provide tailored advice.

In conclusion, while some bleeding after RU486 is expected, significant changes in bleeding patterns warrant further evaluation. It’s essential to maintain open communication with your healthcare provider, adhere to follow-up appointments, and seek immediate care if you experience concerning symptoms. Your health and well-being are paramount, and addressing both physical and emotional aspects of your recovery is crucial.