Pregnancy Bleeding: What to Do When It Resembles Menstruation

Pregnancy bleeding resembling menstruation?

The last menstrual period was on January 7, with a cycle length of 26 to 27 days.
I took a pregnancy test on February 4, which showed a faint positive result.
I continued testing for three days, and the second line became slightly darker but still weak.
On the morning of February 7, about an hour after testing, I started experiencing bleeding similar to menstruation.
In the afternoon, I saw a doctor who performed an ultrasound but did not see the embryo; however, there was evidence of bleeding in the uterus and uterine fibroids.
That day, my blood tests showed B-HCG: 13 and P4: 0.38.
The doctor mentioned that the embryo might be naturally expelled but prescribed oral and vaginal progesterone to support the pregnancy.
Given that I am still bleeding, will continuing the medication help? If I do experience a miscarriage, how long will the bleeding last? How should I calculate my next menstrual period after a miscarriage?

Xiao Duo, 30~39 year old female. Ask Date: 2024/02/08

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, there is a possibility of miscarriage.
The bleeding is generally similar to a menstrual period, and it may occur in about a month and a half.
Wishing you good health.

Reply Date: 2024/02/08

More Info

Experiencing bleeding during early pregnancy can be a distressing situation for many women. It is important to understand that while some bleeding can be normal, it can also indicate potential complications such as miscarriage or ectopic pregnancy. In your case, you mentioned that you had a positive pregnancy test followed by bleeding that resembled a menstrual period. This situation requires careful monitoring and medical evaluation.

Firstly, it is crucial to differentiate between normal implantation bleeding and more concerning types of bleeding. Implantation bleeding typically occurs around the time your period would be due and is usually light and short-lived. However, if the bleeding is heavy, similar to a menstrual period, or accompanied by severe cramping, it could indicate a miscarriage or other complications.

In your situation, the doctor has noted the presence of bleeding within the uterus and a low B-HCG level, which suggests that the pregnancy may not be progressing as expected. The administration of progesterone (both orally and via suppositories) is a common practice to support early pregnancy, especially in cases where there is a risk of miscarriage. Progesterone helps to maintain the uterine lining and can sometimes prevent miscarriage, but its effectiveness can vary depending on the underlying cause of the bleeding.

If a miscarriage is occurring, the duration of bleeding can vary significantly from one individual to another. Some women may experience bleeding for just a few days, while others may have a longer duration. It is also possible for the bleeding to be accompanied by passing tissue or clots, which can be a sign that the body is expelling the pregnancy tissue.

Regarding your question about calculating your next menstrual cycle after a miscarriage, it typically takes a few weeks for hormone levels to return to baseline after a miscarriage. Once your body has returned to its normal hormonal state, you can expect your menstrual cycle to resume. For many women, ovulation can occur as soon as two weeks after a miscarriage, and the next period may follow about four to six weeks later. However, this can vary widely, and some women may experience irregular cycles for a few months following a miscarriage.

It is essential to maintain open communication with your healthcare provider during this time. If the bleeding becomes heavier, or if you experience severe pain or other concerning symptoms, you should seek immediate medical attention. Additionally, if you have any questions or concerns about your treatment or the implications of your bleeding, do not hesitate to ask your doctor for clarification.

In summary, while some bleeding in early pregnancy can be normal, it is crucial to monitor the situation closely. The use of progesterone may help in some cases, but it is not a guaranteed solution. Understanding the potential outcomes and maintaining communication with your healthcare provider will be key in navigating this challenging time. Remember to take care of yourself emotionally and physically, as this can be a stressful experience.

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