Abnormal Bleeding After Abortion: What You Need to Know

Abnormal bleeding after abortion?

Hello, Doctor.
I took the first dose of RU486 on January 26, 2024, and the embryo was successfully expelled.
I then took the uterine contraction medication prescribed by the doctor for nearly a month.
Some tissue remained at the fundus of the uterus and could not be expelled naturally with just the contraction medication.
Therefore, on February 24, I underwent a vacuum aspiration procedure to remove the remaining tissue.
After that, I experienced bleeding for about 3-4 days, which then stopped.
Thinking everything was clear, I had intercourse on March 5 with external ejaculation.
However, this morning, March 8, when I went to the bathroom, I noticed some pink blood when I wiped.
I would like to ask if this is an early onset of my period or if it is residual bleeding from the procedure last week.
Additionally, I have some breast tenderness and am unsure if this is related to my period or something else.
The doctor mentioned that menstruation would typically return about a month after a miscarriage.
Should I count one month from January 26 or from February 24?

J, 30~39 year old female. Ask Date: 2024/03/08

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, since your last menstrual period started on February 24, it is possible that you are experiencing ovulatory bleeding.
Please monitor the situation.
Wishing you good health.

Reply Date: 2024/03/08

More Info

After an abortion, it is not uncommon for women to experience abnormal bleeding, which can be confusing and concerning. In your case, you underwent a medical abortion using RU486 followed by a vacuum aspiration to remove retained tissue. The timeline of your bleeding and the subsequent pink discharge you are experiencing can be attributed to several factors.

First, it is essential to understand that after an abortion, the body goes through a significant hormonal and physical adjustment. The first menstrual cycle after an abortion can vary in timing and characteristics. Typically, menstruation resumes within 4 to 6 weeks after the procedure, but this can differ based on individual circumstances, including hormonal levels and the body’s recovery process.

In your situation, since you had the vacuum aspiration on February 24, it is more appropriate to start counting from that date for your menstrual cycle. The pink discharge you noticed on March 8 could be a few things:
1. Residual Bleeding: It is possible that the pink discharge is residual bleeding from the procedure. After a vacuum aspiration, some women may continue to experience light spotting or discharge as the uterus heals.

2. Menstrual Cycle Onset: Alternatively, this could be an early sign of your menstrual cycle beginning. The first period after an abortion can sometimes be lighter or different in color and consistency compared to your usual menstrual flow.

3. Hormonal Changes: The hormonal fluctuations following an abortion can also lead to breast tenderness and other premenstrual symptoms, which you are experiencing. This is a normal part of your body adjusting back to its pre-pregnancy state.

Given that you had a procedure to remove retained tissue, it is crucial to monitor your symptoms. If the bleeding becomes heavier, or if you experience severe pain, fever, or any other concerning symptoms, you should seek medical attention promptly. Additionally, if the pink discharge continues for an extended period or if you have any doubts about your recovery, it is advisable to consult your healthcare provider for further evaluation.

In terms of self-care and recovery, here are some recommendations:
- Rest and Hydration: Ensure you are getting enough rest and staying hydrated, as your body needs time to heal.

- Avoid Strenuous Activities: Refrain from heavy lifting or vigorous exercise until you have fully recovered.

- Monitor Your Symptoms: Keep track of your bleeding patterns, and note any changes in color, consistency, or volume.

- Follow-Up Care: Attend any follow-up appointments with your healthcare provider to ensure that your recovery is progressing as expected.

In conclusion, the pink discharge you are experiencing could be a normal part of your recovery process or the onset of your menstrual cycle. However, it is essential to stay vigilant and consult your healthcare provider if you have any concerns. Your body is undergoing significant changes, and understanding these changes can help you manage your recovery more effectively.

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