Miscarriage or Menstrual Cycle: Your Symptoms and Next Steps

Is it a miscarriage or a menstrual period?

Doctor, I would like to ask about my situation.
My last menstrual period was on May 27, and I had unprotected intercourse on June 8.
My period did not arrive on June 27, but I experienced mild abdominal pain.
On July 4, I bought a pregnancy test, which showed a faint line, but in the afternoon, it was negative.
On July 10, I had a very light period that lasted less than a day.
On July 11, I tested again, and the result was negative.
On July 18, I suddenly experienced abdominal pain and had a heavy flow with many blood clots, as well as a small tissue that resembled endometrial tissue.
On July 26, I tested again, and surprisingly, it showed positive for pregnancy.
On August 10, I had another menstrual period.
Recently, I told a friend about this, and they mentioned that it sounds similar to their experience with a natural miscarriage.
I am wondering if this is due to irregularities in my schedule causing menstrual irregularities, or if it was indeed a miscarriage.
Over the past few months, I started a new job and have been working late until after 10 PM, often going to bed very late.
I feel like I can’t get enough sleep, and I have been experiencing dizziness.
In mid-July, I fainted twice, and I thought it might be due to lack of sleep.
I previously had faint lines on a pregnancy test, which made me wonder if the test was inaccurate.
Do I need to go to the hospital for further examination?

wei, 20~29 year old female. Ask Date: 2013/08/28

Dr. Lü Lizheng reply Obstetrics and Gynecology

Dear Wei,
It appears to be an early pregnancy followed by a miscarriage.
Since there were positive results on two pregnancy tests, it is likely an early pregnancy.
On July 18, there was a sudden onset of abdominal pain, followed by a heavy menstrual flow with many blood clots, and a small mass resembling endometrial tissue, which suggests a natural miscarriage.
I recommend visiting the hospital for further examination, both to confirm the diagnosis and to check whether the miscarriage has been complete.
Wishing you safety and health.
Sincerely,
Dr.
Li-Cheng Lu
Director, Department of Obstetrics and Gynecology
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2013/08/28

More Info

It sounds like you are experiencing a complex situation regarding your menstrual cycle and potential pregnancy, which can understandably be quite distressing. Based on the timeline you've provided, it appears that you may have experienced a miscarriage, but there are several factors to consider before drawing any conclusions.

Firstly, let's break down the timeline of events:
1. Last Menstrual Period (LMP): You mentioned your last period was on May 27, and you had unprotected intercourse on June 8.
2. Missed Period: You did not get your period on June 27, which could indicate a potential pregnancy.

3. Pregnancy Tests: You took a home pregnancy test on July 4, which showed a faint line, suggesting a possible pregnancy. However, the absence of a line later that day could indicate a very early pregnancy or a chemical pregnancy, where the pregnancy does not progress.

4. Light Bleeding: On July 10, you experienced a brief episode of bleeding, which could be implantation bleeding or an early miscarriage.

5. Heavy Bleeding: On July 18, you experienced heavy bleeding with clots, which is often associated with a miscarriage.

6. Subsequent Pregnancy Test: On July 26, you tested again and received a positive result, which could indicate that your body is still producing hCG (the hormone detected in pregnancy tests) from the previous pregnancy or a new pregnancy if you had unprotected intercourse again.

Given these events, it is crucial to consider a few key points:
- Miscarriage Symptoms: The heavy bleeding and passing of clots can be indicative of a miscarriage, especially if accompanied by abdominal pain. However, not all bleeding during early pregnancy means a miscarriage; some women experience bleeding for various reasons.

- Irregular Cycles: Stress, changes in work schedule, and lack of sleep can significantly affect your menstrual cycle. Your recent work changes and sleep deprivation could contribute to irregularities in your cycle.

- Pregnancy Tests: Home pregnancy tests can sometimes yield false negatives, especially if taken too early or if the urine is diluted. If you suspect you are pregnant, it’s advisable to consult a healthcare provider for a blood test, which is more sensitive and can provide a definitive answer.

Next Steps:
1. Consult a Healthcare Provider: Given your symptoms and the timeline, it would be wise to see a healthcare provider. They can perform a thorough evaluation, including a physical examination and possibly an ultrasound, to determine if you have experienced a miscarriage or if there are other underlying issues.

2. Monitor Symptoms: Keep track of your symptoms, including the amount of bleeding, any pain, and other physical changes. This information will be helpful for your healthcare provider.

3. Address Lifestyle Factors: Since you mentioned long working hours and sleep deprivation, consider strategies to improve your sleep hygiene and manage stress. Chronic stress and lack of sleep can have significant effects on your menstrual cycle and overall health.

4. Follow-Up Testing: If you continue to have irregular cycles or if you experience any concerning symptoms (such as severe pain or excessive bleeding), follow up with your healthcare provider for further evaluation.

In conclusion, while your symptoms may suggest a miscarriage, it is essential to seek medical advice to clarify your situation. Your health and well-being are paramount, and a healthcare professional can provide the necessary support and guidance.

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