Menstrual delay is one of the main signs of pregnancy. Although it is convenient to take a test or go to the doctor to confirm it, the absence of periods is usually a clear indication. So it is not surprising that some women are very alarmed when they find out they are pregnant and still continue to bleed. Is bleeding in pregnancy dangerous? Could this bleeding be menstruation? We have spoken with Alejandra Menassa, an internist specializing in women’s health and president of SESMI (Spanish Society of Integrative Medicine) who has resolved all our doubts about pregnancy and periods.
Bleeding and pregnancy: is it normal for a pregnant woman to get her period?
“No, it’s not normal,” says Alejandra Menassa. If a woman is pregnant and begins to bleed at some point during her gestation period, this bleeding is NOT her period.
“It is a bleeding that has its causes, sometimes milder and other times more dangerous. It can alert us to a threatened abortion, but this is not always the case, although it is always recommended to consult with the gynecologist or obstetrician”, comments the doctor.
So what can be the other causes? Alejandra defines them for us:
- Placenta previa – This means that the placenta is ahead of the baby. It is easier to bleed because the placenta is very close to the cervical os and any little thing can cause bleeding. It is not something that pregnant women should worry about.
- Mild infections: candidiasis, for example, is common in pregnancy and can cause minor bleeding that does not have to affect the health of the baby.
- Ectopic or extrauterine pregnancy: when the zygote implants outside the uterus, usually in the fallopian tubes.
In any case, and in general, small, pink bleeding should not scare us. They are within the normal range as long as they appear very punctually. If the bleeding is intense red and abundant, then it would be necessary to go to the emergency room immediately and consult so as not to endanger either the mother or the baby.
Can a woman be pregnant even though her period has come?
- According to Alejandra Menassa, this can happen, although it is a very rare case and rarely happens. When the fetus is implanted in the uterus, a series of hormones begin to be secreted that cause the inhibition of ovulation and without that ovulation it is impossible for our period to come down. However, sometimes a delay in this hormonal regulation can occur, causing an ovulatory cycle to occur once the pregnancy has already occurred. “This usually happens very early, that is, in the first month of pregnancy. It is impossible for it to happen in later ones”, affirms the doctor.
- We insist that this is not common. Rather, the bleeding that occurs in the first month of pregnancy is implantation bleeding and not period bleeding. And what is implantation bleeding? “When the embryo is going to be implanted in the uterus, it makes a small wound to enter the thickness of the endometrium (which is where the baby will grow later) and it is this small wound that can bleed and be confused with the period,” he explains. Alexandra.
Differences between implantation bleeding and menstruation
What you mainly have to look at to distinguish implantation bleeding from your period is three aspects: quantity, color and duration.
- Implantation bleeding is very light and rare, is usually pink or light brown in color, and occurs in isolation. It can also last a couple of days, but usually it is punctual. It differs very well from the rule.
- Menstruation is much more abundant, its color, especially in the first days, is a more intense red and its duration is much longer. Typically, it lasts five to six days.
When does the period come back after being pregnant?
- If the woman decides not to breastfeed the baby, for whatever reason, it is very likely that the month following the birth there were menstrual disturbances that result in a delay or amenorrhea (absence of menstruation). “As a general rule, in these women, the period usually appears again two months after giving birth,” explains Alejandra Menassa.
- Things change if the woman decides to breastfeed. Breastfeeding can cause the period to reappear up to six months. It all depends on the shots. “As the child grows, fewer lactation doses are required, the doses are spaced out and then the period usually recovers. This is because prolactin levels drop, which is precisely the hormone that causes milk to be generated and ovulation to be inhibited”, concludes Alejandra.