What causes irregular periods after abortive pills? – Dr. Mamatha Reddy YV
What causes irregular periods after abortive pills? – Dr. Mamatha Reddy YV

If you’re recovering from a pregnancy loss, you might be surprised to find that your first period after a miscarriage is a bit different than usual for the first cycle or two. And you may be anxious to know whether the bleeding you’re experiencing is normal.

While you should never hesitate to see your doctor if you’re concerned, keep in mind that changes to your first menstrual cycles after a loss are usually nothing to worry about and do not impact your future potential of giving birth to a healthy baby.

When will you get your first period after you have a miscarriage?

Many women can expect their first period four to six weeks after a miscarriage. The exact timing may vary by several weeks, however, depending on when your hCG levels return to zero. Your body will still think it’s pregnant until this hormone is gone.

A few factors can delay your first period after a miscarriage:

Whether you had a “complete” miscarriage

A “complete” miscarriage means all the pregnancy tissue is gone from your uterus. It may have passed naturally on its own or your doctor may have performed a D&C (dilation and curettage), a procedure that physically removes that tissue from your uterus. In some cases, medications (usually misoprostol and mifepristone) can help complete a miscarriage.

Sometimes, however, fragments of the placental tissue remain in the uterus after a miscarriage (or, more rarely, after a D&C). Miscarriage bleeding may taper off, only to continue a few days later. This doesn’t mean your period has returned; it’s a continuation of a pregnancy loss. Your periods will not return to normal until this pregnancy tissue is gone.

How far along in your pregnancy you were

HCG rises as your pregnancy progresses. The further along you were in your pregnancy, the higher your hCG levels. If you miscarried late in the first trimester or in the second trimester, it will take longer for your hCG levels to return to zero and your periods to resume.

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Whether you had regular periods before your miscarriage

Since your periods will likely be like they were before you conceived, if you had irregular periods, you’ll likely have irregular periods again. That can mean that it may take longer than four to six weeks for your first period after miscarriage to arrive.

How heavy will your first period after miscarriage be?

The first period after a miscarriage may be heavier, longer and more painful. That may be because your body didn’t ovulate this cycle, causing the endometrial lining to become thicker and resulting in a heavier or longer period.

Try not to stress: Your periods won’t be this way forever. Eventually, they will most likely return to the way they were before the pregnancy loss.

If your periods were short and light, they’ll go back to being that way. If they were longer and heavier, you can expect the same once things have settled.

What will your first period after a miscarriage look like?

A woman’s first period after a pregnancy loss is often a little different than usual. Bleeding in your first cycle or two post-miscarriage may be somewhat heavier than usual, and you may notice a bit of clotting due to a heavier flow.

With time, you can expect your periods to look similar to how they did before your pregnancy loss.

What PMS symptoms might come with your first period after miscarriage?

Hormonal fluctuations after a miscarriage can be significant, and the miscarriage itself can be distressing. Sometimes the emotional symptoms women experience after a pregnancy loss may be similar to those of postpartum depression.

In fact, research suggests about 20 percent of women have symptoms of anxiety or depression following a miscarriage, especially those with a history of depression and those who don’t have good social support systems.

Symptoms of depression include loss of interest in things you used to enjoy and hopelessness. If you think you might be experiencing depression, check in with your doctor. Help is available.

Once you get your first period after a miscarriage does that mean you can start trying to get pregnant again?

It’s usually okay to start having sex as soon as you stop bleeding after a miscarriage or D&C, but check in with your practitioner first. The return of your period is one of the first signals that your body is ready to start trying again.

But most pratitioners recommend waiting at least a cycle or two, or two to three months, after your miscarriage before you begin trying to get pregnant again so that your body can have time to heal, and so that you can get your nutritional reserves back up to where they should be to conceive.

Even when you’re physically ready to get pregnant again, however, you may or may not feel emotionally ready.

Some women find that trying to conceive helps them shift their focus and feel more in control over their bodies. Others struggle with worries about another miscarriage or need more time to grieve. Only you and your partner can decide if you’re emotionally ready to try for a baby again.

Also keep in mind that the return of your period doesn’t necessarily mean the return of ovulation. It’s possible that you may have one or more anovulatory cycles after a miscarriage (which means that you get your period but you haven’t actually ovulated).

To figure out if you’re actually ovulating, you’ll need to begin tracking your cycles and looking for signs of ovulation again.

What are your chances of getting pregnant after a miscarriage but before your first period?

It is possible to get pregnant after a pregnancy loss but before your first period because you can ovulate before your first post-miscarriage period. Research has actually found that women may be more fertile in the three months following a miscarriage.

Remember that in order to get pregnant, you need to be ovulating. You may ovulate two to four weeks after you miscarry — or about two weeks before your first post-miscarriage period — if you had regular cycles before conceiving. But not all women ovulate during their first cycle after a miscarriage.

Eager to start tracking your cycles again? Wait until after your first period to resume charting ovulation. Until then, it’s likely that your readings will be all over the place and not very reliable.

Is the first period after a miscarriage painful?

The first period after a miscarriage may be more painful than in the past, especially if ovulation doesn’t take place. That’s because the endometrial lining becomes thicker when you don’t ovulate — and menstrual pains and cramps tend to worsen with a heavier flow.

Keep in mind that your periods should eventually get back to the way they were before your miscarriage given a few cycles.

What does brown discharge with the first period after a miscarriage mean?

Brown discharge is old blood leaving your body. It’s perfectly normal to experience brown discharge for a few days after you have your period.

If you’re experiencing brown or pink discharge instead of usual menstrual blood around the time you expect your period, it could be due to a fertilized egg implanting in the uterine wall. You’ll need to wait another week after implantation before you take a home pregnancy test for accurate results.

When to call the doctor

Call your doctor as soon as possible if your bleeding becomes very heavy at any time after a miscarriage.

Check in with your practitioner if you begin bleeding again a few days after you miscarried, as you may have had an incomplete miscarriage. An incomplete miscarriage is totally normal and common.

Your practitioner, however, may recommend a D&C if it’s necessary to remove remaining placental fragments. He or she may also check your hCG levels to make sure they have returned to zero.

Having a miscarriage can cause intense feelings of loss and mourning. Try to remember that the uterus is incredibly adept at recovering, so you can begin trying for a baby again when you feel emotionally ready.

A good statistic to keep in mind: Most women miscarry just one time and go on to have healthy pregnancies and babies. And plenty of women who do have multiple miscarriages also go on to have viable pregnancies. So try to remain hopeful — and start tracking your periods again as soon as you feel ready.

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