When Will My Period Return After Medical Abortion?

When will menstruation occur after a medical abortion?

Hello, I took RU486 on November 3rd, and I started bleeding on November 5th, during which I likely passed some blood clots.
An ultrasound on November 10th confirmed that the embryo had been expelled, and I was prescribed uterotonics, which I took from November 11th to November 14th.
After November 20th, I stopped bleeding, and a pregnancy test on November 24th showed only one line.
I would like to know if the ovulation period should be calculated starting from the 24th or the 20th.
I had intercourse on November 26th-27th and again on December 3rd-4th, but there was no ejaculation.
As of December 13th, my menstrual period has not yet arrived.
What is the likelihood of pregnancy? Is it advisable to conceive again right after a miscarriage? Additionally, should I calculate my menstrual cycle starting from November 20th when I stopped bleeding, or from November 5th when I began bleeding, for one to one and a half months? Thank you.

Niming, 20~29 year old female. Ask Date: 2022/12/13

Dr. Lin Lixuan reply Obstetrics and Gynecology

After a medical abortion, the first menstrual period may become irregular, making it difficult to calculate the safe period.
It is recommended to use condoms for contraception during sexual intercourse.
If pregnancy occurs, it is advisable to visit a nearby obstetrics and gynecology clinic for a physician to assess whether there are any abnormalities in fetal development and to discuss the possibility of terminating the pregnancy.

Reply Date: 2022/12/13

More Info

After a medical abortion, the timeline for the return of your menstrual period can vary significantly from person to person. Generally, it is expected that your menstrual cycle will resume within 4 to 6 weeks after the procedure, but this can depend on several factors including individual hormonal balance, the timing of ovulation, and overall health.

In your case, you mentioned that you took RU486 on November 3 and began bleeding on November 5, which indicates that the medical abortion process was initiated. By November 10, an ultrasound confirmed that the pregnancy tissue had been expelled, and you were prescribed medication to help with uterine contractions. You reported that bleeding ceased after November 20, and a pregnancy test on November 24 showed a negative result.

Typically, ovulation occurs about 14 days before the start of your next period. If we consider that your bleeding stopped on November 20, ovulation could potentially occur around December 4, assuming a regular cycle. However, since you experienced a medical abortion, your body may take some time to readjust, and ovulation may not occur as predictably as it would in a non-pregnant state.
Regarding your question about the likelihood of becoming pregnant again after the abortion, it is indeed possible to conceive shortly after a medical abortion, especially if you have unprotected intercourse during your fertile window. Since you had sexual intercourse on November 26-27 and December 3-4, there is a chance of pregnancy if ovulation occurred around that time.
As for your menstrual cycle, it is generally calculated from the first day of your last menstrual period (LMP) before the abortion. In your case, since you started bleeding on November 5, you would typically count from that date. If your cycle is regular, you might expect your period to return approximately 4 to 6 weeks after the bleeding stopped, which would place your next expected period around late December to early January.

It is important to note that after a medical abortion, your body may take some time to return to its normal hormonal rhythm, and cycles may be irregular for a few months. If your period does not return within 6 weeks, or if you have any concerns about potential pregnancy, it is advisable to take a home pregnancy test or consult with your healthcare provider for further evaluation.

In conclusion, while there is a possibility of becoming pregnant shortly after a medical abortion, it is essential to monitor your body’s signals and consult with a healthcare professional if you have any concerns or if your menstrual cycle does not resume as expected. Additionally, if you are considering another pregnancy soon after an abortion, it is crucial to discuss this with your healthcare provider to ensure that your body is ready for another pregnancy and to address any potential risks involved.

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