Is It Menstruation or Residual Bleeding After Abortion?

Is it menstruation?

This month's menstrual period was from July 20 to July 25.
After having intercourse with my husband on the 28th, I noticed some blood stains on my underwear.
A little bit again on the 31st after another sexual encounter, and the next day there was a bit more blood.
On August 1st, during a procedure, there was a small amount of blood, and on August 2nd, it felt like the bleeding increased, similar to when menstruation first starts.
I had a miscarriage in early June, but the lochia had stopped for a while.
Could you please advise if this is retained lochia or a menstrual period?

Tiānkōng, 20~29 year old female. Ask Date: 2009/08/02

Dr. Chen Changfu reply Obstetrics and Gynecology

Based on your description, the menstrual period that started on July 20 after the abortion procedure and the abnormal vaginal bleeding in early August should not be related to the abortion.
It may simply be irregular bleeding during your menstrual cycle, commonly referred to as dysmenorrhea.
However, it is still recommended that you consult a gynecologist for examination and treatment.

Reply Date: 2009/08/02

More Info

Determining whether the bleeding you are experiencing is menstruation or residual bleeding after an abortion can be quite complex, especially considering your recent history of a surgical abortion. Here are some key points to consider:
1. Understanding the Phases of Bleeding After Abortion: After an abortion, it is common for women to experience a period of bleeding known as lochia, which can last for several weeks. This bleeding can vary in color and consistency, often starting as bright red and gradually changing to a lighter color as the body heals. Lochia typically subsides within a few weeks, but some women may experience intermittent bleeding for a longer period.

2. Timing of Your Bleeding: You mentioned that your last menstrual period was from July 20 to July 25, and you had sexual intercourse on July 28 and again on July 31, after which you noticed some blood. If your menstrual cycle is regular, you would expect your next period to occur around August 20 to 25. The bleeding you observed after sexual activity could be due to several factors, including hormonal fluctuations, irritation from intercourse, or residual bleeding from your recent abortion.

3. Characteristics of the Bleeding: The nature of the bleeding is also important. If the blood is bright red and resembles a menstrual flow, it may indicate the onset of your period. However, if it is darker and more akin to what you experienced during the lochia phase, it could suggest that residual tissue or blood is still being expelled from your uterus.

4. Hormonal Influence: After an abortion, your hormone levels, particularly human chorionic gonadotropin (hCG), will take time to return to baseline. If you are still experiencing elevated hCG levels, this could affect your menstrual cycle and lead to irregular bleeding. It is important to monitor your hCG levels through blood tests, as a persistent elevation may indicate retained products of conception.

5. Ultrasound and Medical Evaluation: If you are uncertain about the nature of your bleeding, it is advisable to consult your healthcare provider. An ultrasound can help determine if there is any retained tissue in the uterus, which could explain the ongoing bleeding. Your doctor may also perform a physical examination to assess your condition.

6. When to Seek Help: If the bleeding is heavy, accompanied by severe pain, or if you have any signs of infection (such as fever or foul-smelling discharge), you should seek medical attention promptly. These could be signs of complications that require immediate intervention.

7. Future Menstrual Cycles: After an abortion, it may take some time for your menstrual cycle to regulate. Some women may experience changes in cycle length, flow, and symptoms for a few months following the procedure. Patience is key, but if you have concerns about your menstrual health or fertility, discussing these with your healthcare provider is essential.

In summary, distinguishing between menstruation and residual bleeding after an abortion involves considering the timing, characteristics of the bleeding, and any accompanying symptoms. If you are uncertain or concerned, it is always best to consult with your healthcare provider for personalized advice and evaluation. They can provide the necessary tests and examinations to ensure your health and well-being.

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