Bleeding Patterns After Taking RU486: What to Expect

I just had my second dose of blood and it didn't flow much?

Hello Doctor, I would like to inquire about my situation.
On May 15th, an ultrasound showed that the embryo was three weeks old.
On May 16th, I took the first dose of RU486 at the clinic, and the next day I took the second dose at home.
I experienced abdominal cramping, diarrhea, vomiting, and lower back pain, but I didn't have a lot of bleeding.
Instead, after taking the first dose, I had some brown discharge and blood clots the next day, while the second dose resulted in less bleeding.
Should I wait a few more days for more bleeding to occur?

Huang, 20~29 year old female. Ask Date: 2020/05/16

Dr. Huang Yuande reply Obstetrics and Gynecology

Using RU486 for abortion, general bleeding typically occurs around 12 days later, with heavier bleeding following the intake of the second dose.
It is recommended to visit an obstetrician-gynecologist for an ultrasound after taking the second dose to confirm that the uterus is clear.

Reply Date: 2020/05/16

More Info

When taking RU486 (mifepristone) as part of a medical abortion regimen, it is important to understand the expected bleeding patterns and associated symptoms. RU486 is typically administered in two stages: the first dose is taken at a clinic, followed by a second dose of misoprostol taken at home 24 to 48 hours later. The combination of these medications is designed to terminate an early pregnancy, and the bleeding patterns can vary significantly from person to person.

After taking RU486, it is common to experience some abdominal cramping, which can feel similar to menstrual cramps. This is a normal response as the uterus begins to contract and expel its contents. The symptoms you described—abdominal pain, diarrhea, vomiting, and back pain—are also common side effects of the medications. These symptoms can occur as your body reacts to the hormonal changes and the process of expelling the pregnancy.

Regarding the bleeding, it is typical for individuals to experience varying amounts of blood loss after taking these medications. After the first dose of RU486, some may notice light spotting or brownish discharge, which can include small blood clots. This is often due to the body beginning to prepare for the expulsion of the pregnancy tissue. The amount of bleeding can fluctuate; some may experience heavier bleeding after the second dose of misoprostol, while others may not.

In your case, it sounds like you experienced some bleeding and discharge after the first dose, which is not unusual. The fact that you did not have significant bleeding after the second dose does not necessarily indicate a problem. It is important to remember that the timing and amount of bleeding can vary widely. Some individuals may experience heavy bleeding within a few hours of taking misoprostol, while others may have a more gradual onset of bleeding over several days.

If you are concerned about the amount of bleeding or if you experience severe pain, fever, or other concerning symptoms, it is crucial to contact your healthcare provider. They can provide guidance and determine if any further evaluation or intervention is necessary. In general, it is advisable to monitor your symptoms and allow some time for the process to unfold, as it can take several days for the bleeding to reach its peak and then taper off.

In summary, after taking RU486, it is normal to experience a range of symptoms, including cramping and varying amounts of bleeding. If you have any concerns about your symptoms or the bleeding patterns, do not hesitate to reach out to your healthcare provider for personalized advice and support. They can help ensure that you are managing the process safely and effectively.

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