Menstrual Cycle After Medical Abortion: What to Expect

What is the expected time for menstruation to return after a medical abortion?

Hello, doctor...
My girlfriend took RU486 as directed by her physician for a medical abortion on September 13 (1 pill) and September 15 (3 pills).
However, she experienced incomplete uterine contractions and prolonged bleeding.
After returning for a follow-up and continuing the medication, her bleeding stopped at the end of the month, but two days later, she experienced bleeding again that lasted for 4 to 5 days.
The bleeding was mostly brownish, resembling menstrual blood.
As of today, October 22, her menstrual period has still not arrived.
Doctor, typically, we would expect her period to start around October 15.
How many days could it be delayed? Given my girlfriend's situation, how should we interpret this?

Xiao Chen, 20~29 year old female. Ask Date: 2005/10/25

Dr. Dai Qihan reply Obstetrics and Gynecology

It is recommended that you return to the original prescribing hospital for a follow-up examination.

Reply Date: 2005/10/25

More Info

After a medical abortion using RU486, it is common for women to experience irregularities in their menstrual cycle. The timeline for when to expect a return to a normal menstrual cycle can vary significantly from person to person, influenced by several factors including hormonal changes, the body's response to the abortion process, and individual health conditions.

In your girlfriend's case, she experienced an incomplete abortion, which can lead to prolonged bleeding and irregularities in her menstrual cycle. After taking RU486, it is typical for women to have some bleeding as the body expels the pregnancy tissue. This bleeding can vary in duration and intensity. It is not uncommon for the bleeding to stop and then resume, especially if there are remnants of the pregnancy tissue still in the uterus, which can cause further uterine contractions and bleeding.

The coffee-colored discharge your girlfriend experienced is often old blood, which can be a normal part of the healing process. However, if the bleeding persists or is heavy, it is essential to follow up with a healthcare provider to ensure that there are no complications, such as retained products of conception or infection.

Regarding the expected return of her menstrual cycle, it is important to note that after a medical abortion, it can take several weeks for the menstrual cycle to normalize. While many women may expect their period to return within four to six weeks after the procedure, some may experience delays. Factors such as stress, hormonal fluctuations, and the body's recovery process can all contribute to a delayed period. In your girlfriend's case, since she had an abortion on September 13 and 15, it is possible that her cycle may take longer to regulate, especially given the complications she experienced.

If her period does not return within a few weeks, or if she experiences any concerning symptoms such as severe pain, heavy bleeding, or signs of infection (such as fever or foul-smelling discharge), it is crucial for her to consult with her healthcare provider. They may recommend a follow-up ultrasound to check for any retained tissue or other issues that could be affecting her menstrual cycle.

In summary, while it is common for menstrual cycles to be irregular following a medical abortion, the specific timeline can vary. Your girlfriend's experience of delayed menstruation could be attributed to the incomplete abortion and the body's adjustment to hormonal changes. It is advisable to monitor her symptoms and seek medical advice if her period does not return soon or if she has any concerning symptoms.

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