Menstruation during pregnancy and with the pill

How is menstruation during pregnancy?
True menstruation may not occur during pregnancy, but it is possible to have bloody discharge for various reasons.

In some cases, this manifests itself in the form of spots, other times it seems to be a real menstrual cycle.
The causes are different. In most cases, there is no need to worry, but sometimes it can indicate something more serious.
When a woman is pregnant, her body begins to produce human chorionic gonadotropin. A menstrual cycle then no longer occurs.
The percentage of women who experience bloody discharge during pregnancy is about 25-30%.


Causes of bloody discharge during pregnancy

Bloody discharge or bloody stains
Mild bloody discharge may be caused by the implantation of the embryo.
Implantation discharge occurs when the fertilized egg attaches to the uterine wall. This happens five days after conception (in the fallopian tubes) and the bloody discharge persists for a short period of 3-4 days.

Extrauterine pregnancy
Extrauterine pregnancy is one of the most serious causes that occurs when the fetus does not implant in the uterus, but in another area such as the fallopian tube.
Usually, with an extrauterine pregnancy, abdominal cramps, abdominal pain and bloody discharge occur.

Miscarriage (spontaneous abortion)
Bloody discharge during the initial stages of pregnancy, especially within the first three months, may be an indication of spontaneous abortion.
Like extrauterine pregnancy, miscarriage can cause stomach cramps and bloody discharge.

Placental problems
The placenta (placenta) is the vascular structure that is located in the upper part of the uterus and supplies the fetus with nutrients and oxygen. If it comes to diseases of the placenta, it is very easily possible that a bloody discharge occurs.
There are mainly two types of problems of the placenta that can lead to bloody discharge: placenta previa (when the placenta attaches to the lower part of the uterus and covers the cervix) and placental detachment, that is, when the placenta detaches from the uterine wall.

What should you do if you think you are pregnant, but the menstrual cycle persists?

If you think you are pregnant, but there is still a bloody discharge, you should talk to the doctor. These symptoms may be caused by hormones, an abortion, infection, etc.
The only way to know for sure what is the cause of bloody discharge is to be examined by the doctor.

What does it mean if the pregnancy test is negative but menstruation does not occur?
A negative pregnancy test in most cases indicates that the woman is not pregnant.
Sometimes you take the pregnancy test too early. Therefore, he does not indicate pregnancy, because the body has not yet produced HCG hormones. Some pregnancy tests can show a correct result already on the first day after the theoretical start of the menstrual cycle, with other pregnancy tests you have to wait 3-4 days.

Menstruation and birth control pills

The birth control pill is taken according to the length of the normal menstrual cycle. You take the active pills for 21 days of each month and a placebo for 7 days during which menstruation occurs.
The latest contraceptives make it possible to prolong the cycle. Instead of taking the placebo, the active pills are taken every day of the month. Usually you take the pill for three months and then the placebo for 7 days, or you can take the pill for a whole year.

After how many days of taking the pill does menstruation occur?
Taking oral contraceptives, blood flow decreases and menstrual bleeding is shorter.

Bloody spots or spotting
The minipill contains a small amount of estrogen and progesterone, which inhibit the natural hormones that allow the woman to become pregnant.

When does bleeding start before the end of taking the pill?

Sometimes the bleeding is not normal and in these cases a thorough examination by the doctor is advisable, especially since the woman may have a sexually transmitted disease such as chlamydia or gonorrhea (gonorrhea).
You may also have an undiagnosed infection. The risks are increased in women who have not yet had a PAP test.

Causes include:

Uterine polyps
A uterine polyp is a small, benign (non-tumorous) mass of tissue that forms on the inner wall of the uterus.
These tumors are usually benign but can cause abdominal pain and bloody discharge (pseudomenstruation).

Uterine fibroids
The uterine fibroma can be treated with medication and/or surgically removed.
Initially, any fibromas that cause mild symptoms can be treated with painkillers.
If there is heavy bleeding, iron supplements should be taken to prevent or treat anemia.
A low dose of oral contraceptives can reduce bleeding caused by fibromas.
A so-called hormone agonist for the release of gonadotropin is used to reduce fibroma size and bleeding.

The endometrial tissue lining the uterus is expelled every month and flushed out with menstrual blood. Endometriosis occurs when the endometrium begins to grow outside the uterus; often it attaches to the ovary or fallopian tube, other times it grows on other organs such as the intestine or in the area between the rectum and uterus.
Endometriosis can cause bleeding, cramping before and after the menstrual cycle, and pain during intercourse.

Pelvic inflammation
Pelvic inflammation is caused by a bacterial infection that affects the female reproductive system. The bacteria enter through the vagina during sexual intercourse and then spread to the uterus.
The bacteria can also enter the reproductive system after insertion of an intrauterine device, after childbirth or after an abortion.
Symptoms include:

  • abundant vaginal discharge accompanied by an unpleasant odor,
  • irregular vaginal bleeding,
  • pelvic pain,
  • Fever.

Polycystic ovary syndrome
If there is a polycystic ovary, the ovaries produce a large amount of androgens (male hormone) and small sacs with liquid contents (cysts) can form in the ovaries.
The high androgen level prevents the maturation of the eggs, which prevents ovulation from taking place.
Women with polycystic ovaries usually have irregular menstruation.

How are cases of irregular menstrual cycles treated?

Treatment of abnormal menstrual cycles depends on the cause:

  • Regulation of the menstrual cycle: prescribing the pill with the hormones estrogen and progesterone to have a regular menstrual cycle;
  • The pain can be reduced by taking an analgesic such as acetaminophen or nonsteroidal anti-inflammatory drugs such as ibuprofen.
    A hot bath or shower can relieve the pain.

Menstruation after stopping or stopping the pill

After the medication stops, menstruation sometimes does not occur and some women have a delay that can last three months or more.

Avoiding menstruation on holiday

Women who do not want to have menstruation while they are by the sea or in the mountains can continue taking the active pill (instead of the placebo) for a week or two. But you should talk to the gynecologist beforehand.

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