Your First Period After Miscarriage: What to Expect

First Menstrual Period After Natural Miscarriage

On January 17, during the 11th week of my second pregnancy, I experienced a natural miscarriage with continuous light bleeding, sometimes bright red and sometimes brown.
I have been seeing both Western and Traditional Chinese Medicine for examination and treatment.
On February 23, my menstrual period started with heavy bleeding.
That day, the Chinese medicine doctor prescribed medication to reduce the bleeding.
Today is February 27, and the bleeding has not decreased; I am using 35 cm overnight pads, which become saturated immediately and overflow.
There is still a week until my next obstetric appointment, and I am very concerned whether this amount of bleeding is normal.

Xiang Ma, 30~39 year old female. Ask Date: 2015/02/27

Dr. Lü Lizheng reply Obstetrics and Gynecology

In a normal miscarriage, there may be increased bleeding for one to two days, after which the amount of bleeding should gradually decrease.
Since your bleeding has not lessened, there may be an issue, and it is advisable to seek medical attention promptly.
Treatment should be directed at the underlying cause.
There is no need to wait for the next obstetrics and gynecology appointment.
Possible reasons for the continued bleeding include retained placenta or membranes in the uterus, uterine inflammation, poor uterine contractions, hormonal imbalances, or coagulation disorders.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan General Hospital.

Reply Date: 2015/02/27

More Info

After experiencing a miscarriage, it is common for women to have concerns about their first period and the changes in their menstrual cycle. Your situation, where you have experienced heavy bleeding following a miscarriage, is understandably distressing. Here’s what you can expect and some important considerations regarding your menstrual cycle after a miscarriage.

Firstly, it is important to understand that after a miscarriage, your body goes through a significant hormonal shift as it attempts to return to its pre-pregnancy state. This can lead to variations in your menstrual cycle, including changes in the timing, flow, and duration of your periods. It is not uncommon for the first period after a miscarriage to be heavier than usual, as your body may be shedding the uterine lining that was built up during the pregnancy.

In your case, you mentioned that you started your period on February 23rd, and the bleeding has been heavy enough to saturate a 35cm sanitary pad quickly. While it is normal for the first period after a miscarriage to be heavier, it should not be excessively so. Heavy bleeding, defined as soaking through a pad in less than two hours, can be a cause for concern. It may indicate retained products of conception or other complications that need to be addressed.

Here are some key points to consider:
1. Duration and Flow: The first period after a miscarriage can last longer than a typical menstrual period, sometimes up to a week or more. However, if the bleeding continues to be heavy and does not decrease over several days, it is advisable to seek medical attention sooner rather than later.

2. Signs of Complications: In addition to heavy bleeding, you should be aware of other symptoms that may indicate a complication, such as severe abdominal pain, fever, or passing large clots. If you experience any of these symptoms, it is crucial to contact your healthcare provider immediately.

3. Follow-Up Care: Since you have a follow-up appointment with your gynecologist in a week, it is important to monitor your symptoms closely until then. If the bleeding does not improve or worsens, consider reaching out to your doctor for advice on whether you should be seen sooner.

4. Self-Care and Monitoring: In the meantime, ensure you are taking care of yourself. Stay hydrated, rest as needed, and avoid strenuous activities. Keeping track of your bleeding patterns, including the amount and any associated symptoms, can provide valuable information for your healthcare provider.

5. Emotional Support: Experiencing a miscarriage can be emotionally taxing. It is important to seek support from friends, family, or counseling services if you are feeling overwhelmed. Emotional healing is just as important as physical recovery.

In conclusion, while it is not uncommon for the first period after a miscarriage to be heavy, it is essential to monitor the situation closely. If you continue to experience heavy bleeding or have any concerning symptoms, do not hesitate to seek medical attention. Your health and well-being are paramount, and your healthcare provider can offer the best guidance tailored to your specific situation.

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It feels like my period has started, but sometimes it may not be a true menstruation; it could also be vaginal bleeding. It's better to return for a follow-up appointment for confirmation. Sincerely, Dr. Li-Cheng Lu, Taoyuan Hospital.