Ovulation Bleeding After Taking RU486: What to Know

Ovulation bleeding

My girlfriend took RU486 on January 10 and the second dose of three hexagonal pills on January 12.
She now forgets when she started bleeding.
Later, she visited another obstetrician-gynecologist who performed an ultrasound and said it appeared to be clear, but a urine test still showed faint lines.
The doctor said this was normal and suggested that if we were concerned, we could buy a pregnancy test a week later.
Since the doctor confirmed everything was clear, we didn't test again.
The issue is that the doctor mentioned we should track the menstrual cycle from January 14 to January 20.
However, from February 6 to February 8, my girlfriend experienced light bleeding, which was not much.
We checked a menstrual tracking app, which indicated that the ovulation period was from January 30 to February 5.
Could the bleeding during this time be related to ovulation after taking RU486? We also had intercourse during these days.

Linlin, 20~29 year old female. Ask Date: 2021/02/08

Dr. Cai Yonglong reply Obstetrics and Gynecology

After an artificial termination of pregnancy, the ovulation days can be irregular the following month, making it difficult to determine the fertile window.
As a result, there is a high chance of becoming pregnant again soon.
It is advisable to visit an obstetrics and gynecology clinic, where you may consider taking emergency contraception.

Reply Date: 2021/02/08

More Info

Understanding ovulation bleeding after taking RU486 (mifepristone) can be complex, especially when considering the hormonal changes that occur during and after a medical abortion. RU486 is primarily used in combination with misoprostol to terminate a pregnancy, and it works by blocking the hormone progesterone, which is necessary for maintaining pregnancy. After taking RU486, the body undergoes significant hormonal shifts, which can lead to various symptoms, including bleeding.

In your girlfriend's case, she took RU486 on January 10 and followed up with the second dose of misoprostol on January 12. It’s common for women to experience bleeding after taking these medications, which can vary in amount and duration. The bleeding is often heavier than a typical menstrual period and can last for several days. The timeline you provided suggests that the bleeding she experienced from January 14 to January 20 could be attributed to the effects of the medications.

Regarding the light bleeding she experienced from February 6 to February 8, this could potentially be linked to ovulation. After a medical abortion, it is possible for a woman to experience a return to her menstrual cycle relatively quickly, and ovulation can occur as soon as two weeks after the procedure. The light bleeding during the ovulation period could be considered "ovulation spotting," which is a common occurrence for some women when they ovulate. This is typically light and lasts for a short duration.

The faint lines on the pregnancy test indicate that there may still be residual hCG (human chorionic gonadotropin) in her system. After a medical abortion, it can take some time for hCG levels to return to zero, which is why the doctor mentioned that seeing faint lines can be normal. If the ultrasound indicated that everything appeared to be "clean," it suggests that the abortion was successful, but it’s still essential to monitor hCG levels if there are any concerns.

If your girlfriend is tracking her menstrual cycle and using an app, it’s important to note that the app may not accurately predict ovulation immediately following a medical abortion, as the body is still adjusting hormonally. The app might have indicated an ovulation window from January 30 to February 5, which aligns with the typical cycle length, but individual variations can occur, especially after hormonal changes from medications like RU486.

In summary, the light bleeding your girlfriend experienced could be related to ovulation, especially if it coincided with her predicted ovulation window. However, if there are any concerns about the bleeding, the faint lines on the pregnancy test, or any other symptoms, it is advisable to follow up with a healthcare provider for further evaluation. They may recommend a repeat pregnancy test or additional monitoring to ensure everything is progressing normally.

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