Post-Medication Abortion Symptoms and Pregnancy Testing

Medication abortion

On September 5th, I underwent a medical abortion with the second dose.
A week later, after confirming that the bleeding had stopped, I engaged in sexual intercourse, using condoms throughout and ensuring that no semen was released.
However, on September 17th, I experienced heavy bleeding (the doctor mentioned that the endometrium was still unstable and advised monitoring).
Currently, the bleeding has normalized.
During a follow-up appointment on September 28th, I took a pregnancy test and had an ultrasound, confirming that the embryo had been expelled.
Recently, I have started to experience dizziness similar to early pregnancy, occasionally accompanied by nausea (though not as severe as the dizziness and vomiting experienced during confirmed pregnancy).
I purchased a pregnancy test and observed a very faint second line.

Q: 1.
Does this indicate that I am pregnant, or could it be a result of HCG levels not having dropped yet?
2.
If I am not pregnant, could the dizziness and nausea be due to excessive blood loss after the medical abortion?
3.
Should I wait and monitor for a while before testing for pregnancy again?

Amber, 20~29 year old female. Ask Date: 2020/10/02

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, a new pregnancy or incomplete miscarriage are both possible.
It is recommended to return to your original clinic for follow-up.
Wishing you good health.

Reply Date: 2020/10/02

More Info

In addressing your concerns regarding post-medication abortion symptoms and pregnancy testing, it is essential to understand the physiological changes that occur after a medical abortion and how they can affect subsequent pregnancy tests and symptoms.

1. Understanding the Pregnancy Test Results: The presence of a faint line on a pregnancy test can indicate a few possibilities. If you have recently undergone a medical abortion, it is possible that the human chorionic gonadotropin (hCG) levels have not yet returned to baseline. After an abortion, it can take several days to weeks for hCG levels to decrease significantly, depending on how far along the pregnancy was before the abortion. Therefore, a faint line could suggest that hCG is still present in your system, which is common after a medical abortion. However, if you are experiencing symptoms consistent with early pregnancy, such as dizziness and nausea, it is also possible that you could be pregnant again, especially if you engaged in unprotected intercourse after the abortion.

2. Symptoms Post-Abortion: The symptoms you are experiencing, such as dizziness and nausea, can be attributed to several factors. After a medical abortion, your body undergoes significant hormonal changes, and it may take time for your menstrual cycle and hormone levels to stabilize. Additionally, if there was any significant blood loss during the abortion, it could lead to symptoms of anemia, which can include dizziness and fatigue. If you are concerned about excessive bleeding or if the symptoms persist or worsen, it is crucial to consult your healthcare provider for further evaluation.

3. Next Steps and Monitoring: It is advisable to monitor your symptoms closely. If the faint line on the pregnancy test persists or if you continue to experience symptoms of early pregnancy, you should follow up with your healthcare provider. They may recommend a quantitative hCG blood test, which can provide a more accurate measurement of hCG levels and help determine whether you are pregnant or if your levels are decreasing as expected after the abortion. This test can help clarify whether the symptoms you are experiencing are due to residual hCG or a new pregnancy.

In summary, after a medical abortion, it is not uncommon for hCG levels to take time to drop, which can lead to faint lines on pregnancy tests. Your symptoms could be related to hormonal changes, residual hCG, or even a new pregnancy. It is essential to keep in close contact with your healthcare provider to ensure that you receive appropriate care and guidance during this time. Regular follow-ups and monitoring will help ensure your health and well-being as you navigate this period.

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