Menstruation during pregnancy?
Yes, women have often asked me this question not because they
actually experienced it themselves but because they heard someone, a
sister or friend reported the same problem.
I will discuss in this
article the likelihood of this occurrence and the main premise or
assumption that drives this thought amongst most women.
Is It True?
By principle, menstruation during pregnancy is out of place. It is actually an oxymoron indeed.
uprising of this question of menses during pregnancy is not really
because it is a complex issue to understand. It is simply because by
mouth-to-mouth women talk, it has gained some popularity amongst women
and almost appears as though it is true. In fact what drives this is
word of mouth that …’ some relative here or a friend there has
reported having had her period during pregnancy”.
The Main Error In This Myth
The major error in this misconception is that proponents of this idea
call any brief vaginal bleeding “menses”. Even in an woman who is not
pregnant, menses is not synonymous to vaginal bleeding. Menstrual bleed
is a well-defined physiologic process resulting from well known
hormonal interactions. Menses is just one type of vaginal bleeding,
which is not a disease!
The different types of vaginal bleeding
result from different mechanisms. Pregnancy hormones make menses not to
be possible. In fact the very presence of pregnancy abolishes menses.
Why? The typical hormonal pattern during the ovulation cycle
that results in menses cannot occur during pregnancy. Bleeding not
caused by this known hormonal interplay is not menses, though still
vaginal bleeding of another cause.
It is important to recognize
this because any “menstrual-like” bleeding during pregnancy warrants
medical attention. Mislabeling it menstruation may result in adverse
outcomes. However, there are minor vaginal bleeding episodes that may
occur during pregnancy.
What Could It Be?
Bleeding during pregnancy may have multiple causes. Most importantly,
there may be slight spotting during the first month. Two trivial
- Implantation bleeding. As the zygote, the fertilized egg, digs her way into the endometrium, some mild bleeding may occur.
- Bleeding around the 13-14th day of pregnancy
that results as the ” baby placenta” is adapting itself on the uterine
wall. Remember also that by the date of expected menses, any pregnancy
is about 14 days old in a 28-day cycle!
are three major early pregnancy complications that must not be mistaken
as menstruation during pregnancy. Seek medical attention.
- Ectopic pregnancy
This is when the embryo implants outside the normal zone within the
uterus, commonly in the tubes. Mild dark bleeding may occur, associated
with a positive pregnancy test and lower abdominal pain.
is a spontaneous abortion. It may just be a threatened abortion with
bleeding and pelvic pain without loss of the pregnancy.
- Molar pregnancy. The pregnancy is abnormal, usually with no baby but with a positive pregnancy test, bleeding and even abdominal swelling.
During the second and third trimester, the causes of bleeding through the vagina are generally different, such as
- Late abortion or premature labor
- Placenta position problems including placenta previa and placenta abruptio
In conclusion, not all bleeding through the vagina is menses. Normal menstruation is a precise physiologic process driven by a known interplay of hormones.