Menstruation and pregnancy are phenomena that, in fact, contradict each other, most women believe. And they are right. But there are some situations that you should be aware of, both in the case of planning a pregnancy, and in the case of unprotected intercourse and the risk of an unwanted pregnancy. To understand the essence of the changes taking place in the body, we will touch on some issues of anatomy and physiology.

The wall of the uterus consists of three layers: the endometrium, myometrium (a muscular layer consisting of multidirectional smooth muscle fibers) and the serosa (outer membrane).

The endometrium is the inner mucous layer of the uterus, which changes its structure and thickness depending on the phase of the menstrual cycle. It has two layers: basal (basic) and functional. The functional layer is actively transformed during the phases of the cycle and is responsible for preparing the site for the introduction of a fertilized egg.

Consider how the endometrium changes during the cycle. The menstrual cycle is considered from the first day of menstruation, during which the functional layer of the endometrium is rejected and the basal layer is exposed. Then, until the middle of the cycle, the functional layer gradually grows, increasing its thickness and density. Starting from the middle of the cycle, the woman's body is preparing for the theoretically possible onset of pregnancy. The functional layer of the endometrium under the influence of hormones becomes juicy, loosened and prepares for the implantation of a fertilized egg.

If fertilization occurs and the introduction of the egg into the endometrium, then hormonal changes begin, aimed at maintaining pregnancy. The functional layer is gradually transformed further, taking into account the growth of the embryo.

If fertilization does not occur, then the functional layer of the endometrium is rejected "as unnecessary" - this will be menstruation.

During pregnancy, the function of maturation of the next egg is “turned off” with the help of hormonal changes (the level of chorionic gonadotropin or hCG, prolactin and progesterone increases). Thus, it becomes clear that full menstruation and pregnancy are incompatible.

Normally, there should be no menstruation or other bleeding during pregnancy. However, there are some exceptional situations when the so-called “color pregnancy” is formed, that is, cyclic bleeding is present in the early stages, but the pregnancy develops normally.

When spotting is present on the calendar date, and the pregnancy is progressing normally?

1. Implantation period. During the implantation period, the fertilized egg is introduced into the prepared loose and juicy endometrium. Abundant blood supply to the inner mucous layer of the uterus can lead to the fact that bleeding occurs. Bloody discharge is usually moderate in amount, red (not dark), observed for several days, ending in a spotting scanty discharge. In the classical version of the norm (and at the current level of gynecological morbidity this is becoming less common), ovulation occurs on the 14th day from the beginning of the cycle, implantation occurs on the 5th - 7th day. However, ovulation may be “late”, and implantation may occur a little later (more on this option below) and implantation bleeding coincides in time with the date of the expected menstruation.

2. Pregnancy before menstruation. The common belief that it is impossible to get pregnant before menstruation is again based on the knowledge that ovulation occurs in the middle of the cycle. But, as already mentioned, ovulation can occur later than day 15, and spermatozoa retain their fertilizing ability for about 7 days. And if fertilization occurred in the days before menstruation, then the body "does not have time to cancel" the bleeding. And the delay will happen next month.

It is also possible to get pregnant during menstruation, only the first day of menstruation can be considered relatively “safe”. But sexual intercourse during menstruation is in itself not the best situation for the female body, so relying on this knowledge is not recommended.

3. late implantation. A fertilized egg can “wait” for implantation for up to two weeks and simply does not have time to infiltrate the endometrium before menstruation. Pregnancy progresses, and menstruation comes on time and looks like normal for this woman.

There are no hormonal changes at this stage of pregnancy, which means that menstruation does not cancel. The delay in menstruation occurs for the next cycle and the expected gestational age, to the surprise of the patient, is not 4-5 weeks, but 8-9 weeks.

4. Maturation and fertilization of two eggs at the same time. If the eggs are implanted unequally deep, then one of them may be rejected. In this case, menstrual-like bleeding will occur against the background of a progressive singleton pregnancy. The pregnancy test will be positive, hCG will correspond to the term in a singleton pregnancy.

5. Bleeding from the cervix. Bleeding that coincides with the expected periods, but resulting from a gynecological examination or sexual intercourse. Bloody discharge can be associated with increased vulnerability of the edematous cervical mucosa (during pregnancy, the mucosa swells, is abundantly supplied with blood and is easily damaged by mechanical action) or with various pathologies of the cervix.

Warning symptoms

If you did not protect yourself or there were errors in taking oral contraceptives, your period came on time, but:

1. menstruation is short, less abundant or present in the form of spotting,

2. period came earlier by 2 - 7 days,

3. menstrual flow had an unusual color: dark, brown or vice versa light pink, watery,

4. menstruation was accompanied by unusual sensations (more pronounced pain above the womb and in the lower back, nausea, impaired stool, dizziness, changes in breast sensitivity)

THE POSSIBILITY OF PREGNANCY IS NOT EXCLUDED.

Some women have the listed sensations from cycle to cycle, it is precisely the newly appeared symptoms that should alert.

Coitus interruptus, calendar and temperature methods are not any reliable methods of contraception.

Whether you plan to keep the pregnancy or are set to terminate, in any case of the above, you should consult with an obstetrician - gynecologist.

Menstruation during pregnancy

How to distinguish the norm and pathology if you know about your pregnancy? On your own, you will not be able to distinguish a threatening situation from a safe state, so the final decision always rests with your doctor.

There are symptoms that should alert you at any stage of pregnancy, and in combination with bleeding, similar to menstruation, especially:

Pain in the lower abdomen and lower back (such pain may indicate a threatened miscarriage)

Pain in the right or left iliac region, tension in the abdominal muscles in the area of ​​pain (it is necessary to exclude ectopic pregnancy)

General weakness, dizziness, nausea, vomiting (it is necessary to consult a gynecologist and a surgeon).

If these symptoms appear, you can contact your antenatal clinic, or call an ambulance. It all depends on the severity of your symptoms. You should never refuse additional consultations of specialists (general surgeon, infectious disease specialist, and others) and the proposed treatment in daytime or round-the-clock conditions.

An emergency condition in which it is necessary to immediately call an ambulance team and go to the nearest obstetric facility is profuse bleeding from the genital tract, combined with or without abdominal pain. In this case, waiting for a doctor's consultation and actively moving around is simply dangerous, you risk not only losing your pregnancy, there is a danger to your health, and, in critical situations, a danger to life. Bleeding associated with the female reproductive system can be very massive and transient.

Examination:

Menstruation (or similar spotting) during pregnancy is always a reason to immediately contact an obstetrician - gynecologist. It happens that a woman, having listened to the advice of strangers, believes that menstruation in the early stages of pregnancy is "sometimes" and "someone likes it." However, the cases of “safe” bleeding during pregnancy described above are rather an exception and very rare situations.

1. If you suspect pregnancy, but do not know for sure about it, you need to:

Make an appointment with a gynecologist (bimanual examination, examination of the cervix in the mirrors to exclude bleeding in the pathology of the cervix, taking a smear),

Ultrasound of the pelvic organs (search for the fetal egg and its location, in the uterus or ectopic, determining the heartbeat of the embryo).

2. If you know you're pregnant and you're on your period:

Urgent examination by an obstetrician-gynecologist,

Ultrasound of the pelvic organs (search for the fetal egg, its location, exclusion of a combination of uterine and ectopic pregnancy, the presence of a heartbeat of the embryo / embryos, the presence of retrochorial hematoma and signs of detachment of the fetal egg),

Colposcopy (examination of the cervix using a microscope) is used strictly according to indications, if there is a suspicion of a serious pathology of the cervix, which may require treatment, despite pregnancy and it is impossible to postpone treatment until the postpartum period.

Possible complications:

In order to calm down and calmly bear a pregnancy, it is necessary to exclude all possible causes of spotting during pregnancy in the early stages. This:

1. the threat of termination of pregnancy with detachment of the ovum or the formation of a retrochorial hematoma

2. ectopic pregnancy (the discharge is darker, accompanied by pain in the lower abdomen)

3. pathology of the cervix and external genitalia.

If the main causes of bleeding are excluded, with dynamic observation it is clear that the fetus is developing normally, then you should calm down and just be regularly observed by your obstetrician - gynecologist.

Episodic cases are described when regular menstruation was present from early to late pregnancy, the child developed normally, and there was no threat to gestation. There is no exact explanation for this, as well as a sufficient number of cases to study.

You are responsible for your pregnancy, and you should not make any decisions based on the experiences of others. Register at the antenatal clinic up to 12 weeks, visit the doctor regularly and follow the recommendations - this is what depends on you. If you have any doubts, complaints or questions, always consult your doctor. An unusual course of pregnancy is not always a pathology, but to make sure of this, efforts must be made. Look after yourself and be healthy!

Obstetrician-gynecologist Petrova A.V.

The absence of the next menstruation is almost always a sure sign of the onset of pregnancy. It is the absence of menstruation on time that makes a woman usually buy a test or do a blood test to find out if she is carrying a baby under her heart. But sometimes, even after conception, a woman may notice bloody menstrual-like discharge from the genitals. Can menstruation continue in early pregnancy, we will tell in this article.

The mechanism of menstruation

To understand it, you need to clearly understand how exactly menstruation takes place in the female body. In medicine, they are often called regulations, since menstruation is a regular phenomenon. Bleeding is accompanied by rejection of the mucous membranes of the uterus. The main reproductive female organ gets rid of the functional layer of the endometrium only if there is no need for it - there is no pregnancy.

Typically, a woman's menstrual cycle after puberty is completed lasts 28 days. However, both longer and shorter cycles (20-21 days or 34-35 days) are also considered perfectly normal, provided they are regular. The first day of menstruation is the beginning of a new menstrual cycle. At the end of physiological bleeding, the follicular phase begins.

An egg matures in the ovaries, which will leave the follicle around the middle of the cycle. When the follicle becomes large, under the action of special hormones it ruptures, the egg is released into the ampullar part of the fallopian tube. This process is called ovulation. If on the day of ovulation or a day later, the egg meets the male germ cell - sperm, then conception and pregnancy are likely.

Enter the first day of your last menstrual period

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If conception does not occur, the egg dies 24-36 hours after leaving the follicle. The villi inside the fallopian tube push it into the uterine cavity. The mucous membranes of the genital organ thicken under the influence of progesterone from the moment of ovulation. The functional layer is necessary so that a fertilized egg can gain a foothold in it. If a dead egg descends into the uterus, progesterone levels drop after about a week. The luteal phase of the menstrual cycle (its second half) ends.

The unclaimed physiological layer of the endometrium of the uterus begins to be rejected - menstruation begins, and at the same time - the next menstrual cycle.

If conception has taken place, then the level of progesterone remains high. Approximately 8-9 days after ovulation, the fertilized egg, passing through the fallopian tube, enters the uterus, is introduced into the endometrium, which is loose and “prepared” for implantation. The hormone hCG begins to be produced, for which the chorion villi are responsible after the successful fixation of the fetal egg. Chorionic gonadotropin stimulates additional production of progesterone. “Customized” hCG, progesterone does not decrease. Rejection of the endometrial layer does not occur. Menses do not come.

Menstrual blood is called blood very conditionally, because it does not have the ability to coagulate. In fact, during menstruation, menstrual fluid is released from the genitals of a woman, which only partially consists of blood and uterine membranes. In addition to them, the fluid is determined by the mucus secreted by the cervix, the liquid secretion of the glands of the vagina, a number of enzymes that do not allow the bloody fluid to coagulate.

The average amount of menstrual fluid in one cycle is about 50-100 milliliters. There are less and more abundant periods. However, the volume of fluid lost less than 50 ml or more than 250 ml is considered a sign of pathology - such a woman must be examined and find out the causes of the violation.

Do they happen after conception?

By nature itself, everything is provided so that after conception, if it took place, there would be no menstruation. From the point of view of physiology, the onset of menstrual bleeding becomes completely impossible, but in practice anything can happen, because we are not talking about a machine or mechanism, but about a living human body.

It is no coincidence that some women, when contacting a gynecologist, claim that they came for the first time to an appointment only because other symptoms of pregnancy appeared - breasts enlarged, weight began to grow, and some even had the first fetal movements. In fact, during the first trimester, these women continued to bleed monthly, which they mistook for menstruation. People used to say about such “menstruation” against the background of pregnancy that “the fetus is washed”.

What is really happening? From a medical point of view, there is a small chance that in the follicular phase of the menstrual cycle, a woman will mature not one, but two or three eggs. Their output of their follicles will not necessarily be simultaneous. Imagine that one egg came out, "waited" for a day and died without meeting with the sperm. She descends into the uterus. In the body, processes begin that precede normal menstruation.

But the second egg may well be fertilized. While it moves into the uterine cavity through the tube (this is about 8 days), menstruation may well begin, which arose due to the death of the first egg. However, such periods will be noticeably different from the usual ones. A woman can pay attention to the fact that the discharge, although it came on time, was more meager, did not last 6 days, as usual, but only 3-4 days or less.

It must be said that this is the only more or less explainable and logical reason for the onset of menstrual discharge during pregnancy in the very early stages. A month later, under such circumstances, menstruation will no longer occur, since the pregnancy will already develop in full swing.

Women who claim that their periods continued every month until the end of 3-4 months are mistaken. Even if they had menstrual bleeding in the first month due to the second egg, then in the following months it was not about menstruation, but about pregnancy pathologies - the threat of miscarriage, hormonal disorders or other reasons.

Sometimes gynecologists do admit that a woman may continue to have a bloody "daub" on the days on which her period began before pregnancy. The reason for this phenomenon is not fully understood and experts tend to believe that the hormonal memory of the body is “to blame” for everything. In fairness, it should be noted that such a phenomenon is very rare in practice - in about 0.5-1% of cases.

Discharges of unclear etiology are spoken about if a complete and detailed examination of a pregnant woman does not reveal the slightest disturbance in her condition - the woman is healthy, there is no threat of miscarriage, placenta previa, the balance of hormones is normal, the fetus is healthy and develops according to gestational age.

Usually, such inexplicable discharge disappears by the end of the first trimester and does not return until the very birth. Given the rarity of such a phenomenon, you should not particularly rely on the fact that the spotting that appeared in the early stages is just such a harmless and mysterious menstrual bleeding. Most often, the reasons are completely different, more dangerous and threatening.

To answer the main question of this article - can there be menstruation in the early stages, you need to clearly understand that In 99% of cases this is not possible. And only in rare cases can there be menstrual-like bleeding (not menstruation!) Due to the second egg. In all other cases, the appearance of spotting is an alarming symptom that has nothing to do with the variants of the physiological norm.

Causes of blood in the early stages

So, full and harmless periods during pregnancy are impossible. So what are the reasons for spotting, which women take for menstruation?

Implantation

Implantation bleeding is not universal and does not happen to everyone. But if it happens, then there is nothing dangerous in it. Secretions of a bloody or smearing nature may appear about a week after ovulation, when a fertilized egg reaches the uterine cavity. Usually, a woman who does not realize that conception could have occurred is surprised and thinks that for some reason the menstruation simply came about a week ahead of schedule.

In fact, the blastocyst is introduced into the functional layer of the endometrium of the uterus. During this process, the integrity of the layer is broken and slight bleeding is possible. Such secretions are usually scarce, they are not accompanied by pain. The color of the discharge can be from creamy pink to pronounced bloody. The number of withdrawals is small. Usually, implantation bleeding lasts from several hours to a couple of days, no more.

Tests will show pregnancy in about ten days, and a blood test for hCG will determine it in three to four days after a strange and untimely "daub".

Implantation bleeding does not affect the development of pregnancy in any way; it does not harm the fetus and the health of the expectant mother. For many women, it does not occur at all, or scanty discharge goes unnoticed.

Hormonal imbalance

The cause of spotting, including on the days on which a woman previously had menstruation, may be a lack of the hormone, progesterone, which is important for bearing a child. A sufficient level of this hormone is necessary to prevent another menstruation while a woman is carrying a baby. In addition, progesterone suppresses the mother's immunity, provides nutritional reserves for the baby, maintains the smooth muscles of the uterus in a calm state, preventing tone and hypertonicity of the uterine muscles.

The cause of progestrone deficiency is most often pathologies of the corpus luteum of the ovaries, chorion, chronic diseases of the kidneys and liver, thyroid gland, pituitary disorders, as well as gynecological inflammatory diseases of the ovaries, fallopian tubes, endometrium. Previous abortions are another reason why your own progesterone may be pathologically lacking during a desired pregnancy.

The cause of the appearance of spotting may also lie in the lack of the hCG hormone. If it is not enough, then the stimulation of progesterone production will be insufficient. Hormonal bleeding very often leads to spontaneous abortion if left unattended. However, with a timely visit to the doctor, a woman is prescribed treatment with hormonal agents - progesterone preparations, thus the deficiency of this most important substance can be eliminated. When such a problem occurs, hormonal treatment is usually prescribed for a long course, up to 16-18 weeks of pregnancy, when the threat of miscarriage is considered less likely.

Hormonal secretions can be different in intensity, color and duration. What they are depends on the individual characteristics of the organism. Most often, women complain of the appearance of bloody discharge of a red or brownish color, with impurities of mucus, but both pink and bright orange discharge are characteristic of the pathology.

The more abundant the discharge, the more likely the adverse outcome. When blood clots appear in them, we are often talking about a miscarriage that has begun.

Additional symptoms - pulls the lower abdomen, the lower back aches, weakness and deterioration in well-being are observed. Such signs are not always observed, sometimes the only sign of hormonal deficiency is abnormal discharge from the genitals.

Injury

The genital tract of a woman during pregnancy from the very first months becomes more vulnerable, because progesterone has a softening effect on the mucous membranes. Therefore, injuring the vagina or cervix becomes as easy as shelling pears, without even committing any dangerous actions for this. Mucous membranes during pregnancy are better supplied with blood, the amount of which, by the way, also increases. That is why even a microtrauma of the vagina can lead to the appearance of spotting, which a woman can mistake for menstruation.

Usually, a woman receives such injuries during sex, especially if partners, with the onset of an “interesting position”, did not reduce the intensity of frictional movements, continue to use sex toys and generally make love often. After intercourse, in this case, a woman may notice scarlet spotting - the blood does not have time to change color, because it immediately flows out.

The discharge is not abundant, it is not accompanied by pain, the child is not harmed.

If the cervix is ​​injured, the discharge is stronger, with mucus impurities. A woman can be injured during masturbation, with the introduction of a tampon (which is prohibited during pregnancy!), As well as during a vaginal examination by a gynecologist.

Post-traumatic discharge is not long-term, usually it stops completely after a few hours. If you do not bring the infection to the place of injury, then inflammation will not occur and nothing will threaten the bearing of the baby. In some cases, with excessive and pure bleeding of the vagina, the doctor may prescribe a woman a more gentle mode of intimate life, as well as iron preparations and hemostatics that improve blood clotting.

Ectopic pregnancy

If a fertilized egg is fixed not in the uterine cavity, but in the fallopian tube, cervix, or even enters the abdominal cavity, then for some time the woman may not even know about it. The tests will be "striped" and even signs of toxicosis are quite possible. However, a pregnant woman may be disturbed by smearing brownish discharge, which at first is associated with an insufficient level of hCG, because less of it will be produced during ectopic attachment of the fetal egg.

As the embryo grows, the walls and membranes of the organ to which the fetal egg is attached will stretch. There are quite localized pains in the abdomen, the discharge intensifies. A rupture of the tube or the occurrence of cervical bleeding can be indicated by severe cutting pains, the occurrence of pain shock, loss of consciousness, profuse scarlet bleeding with large clots. The rupture threatens by the end of 8-12 weeks, if the fact of an ectopic pregnancy was not established by ultrasound earlier than this period.

An ectopic pregnancy can be deadly for a woman. For the fetus, there is always only one prognosis - it will not be able to survive anywhere except the uterine cavity. An ectopic pregnancy needs surgery, and the sooner this is done, the more chances a woman will have of pregnancy in the future.

With early detection of pathology, doctors can save the fallopian tubes, the extraction of the fetal egg will be carried out by the laparoscopic method. With late treatment, alas, most often the pipe cannot be saved. With cervical pregnancy, it is often necessary to remove the entire uterus, but the cases of attachment of the fetal egg in the cervix are a relative rarity.

Miscarriage

The threat of miscarriage in the early stages can occur for a variety of reasons, and these reasons will not always be obvious. The fetus may be rejected by the mother's own immunity, it may not be viable due to gross genetic pathologies, developmental anomalies. The threat of miscarriage often occurs in women who have chronic diseases, reproductive health problems of infectious and non-infectious origin.

Early pregnancy is very fragile. Improper nutrition of the expectant mother, her psychological experiences, stress and shock, hard physical work and sports, bad habits (smoking and alcohol), night shift work can disrupt its normal course. Miscarriages can be habitual, repeated. At the same time, it is highly likely that the next one will occur exactly at the same time as the previous one.

The threat of miscarriage is often accompanied by discharge with blood. Their intensity, color, consistency depend on the true cause of the threatening condition. With the appearance of discharge, similar to menstruation, a woman definitely needs an examination by a gynecologist and ultrasound.

With a threatened miscarriage, the fetal egg is usually not deformed, but the uterus is in an increased tone. With the onset of a miscarriage, the discharge is more abundant, the woman complains of increased anxiety, that her stomach hurts, and her lower back is pulled. The pain may be cramping. On ultrasound, a deformed fetal egg of irregular shape is determined. With a miscarriage, bleeding is severe, pain is cramping, large blood clots and fragments of the endometrium and fetal egg are present in the discharge. On ultrasound, the fetal egg may not be determined or its remains are determined. The fetal heartbeat is not recorded.

Modern medicine has many ways to help a woman and her child with a threatened miscarriage and even with a miscarriage that has begun. But with what has happened, doctors, alas, can do nothing. The only solution would be curettage of the uterine cavity in order to avoid the retention of a part of the membranes in it and the subsequent occurrence of an inflammatory process and sepsis.

Chorionic presentation, detachment

If the fetal egg is fixed not in the bottom of the uterus, but at its very bottom, then the occurrence of bleeding due to small detachments of the chorion is not excluded. The presentation may be complete, when the entire cervical region of the cervix is ​​​​covered, or it may be partial. Diagnosis of such a pathology can only be done by ultrasound.

The reasons why pathology occurs most often have a maternal factor, that is, they are directly related to a burdened history - the presence of curettage and abortion in the past, the presence of a tumor in the uterus, polyps, which prevented the blastocyst from gaining a foothold where the development of the fetus would be safer.

The uterus increases in size, new blood vessels appear in the chorion, which should turn into a placenta by the beginning of the second trimester of pregnancy. Detachments occur during presentation due to injuries to the blood vessels.

If the blood does not come out, but accumulates between the wall of the uterus and the chorion, a retrochorial hematoma is diagnosed. With her, there may not be any discharge and this is the most unfavorable sign.

If blood comes out, there is a chance that the hematoma will resolve and the pregnancy will develop further. Discharge, if present, is most often brown. If scarlet blood has gone, this is a sign of fresh detachment, and the likelihood of losing a child due to total detachment is higher.

Frozen pregnancy

A child in the womb can stop developing and die at any time. There can be many reasons - from chromosomal abnormalities that made it impossible for the crumbs to continue to exist, to external adverse effects of toxins, radiation, medicines, and infectious diseases.

Until a certain time, a woman may not be aware of what happened until she goes for an ultrasound scan or she begins to have discharge that resembles menstruation. The dead fetus is usually rejected by the uterus 2-3 weeks after death. During this time, a woman can pay attention to the fact that her signs of toxicosis have disappeared, her chest has stopped hurting. If there was no toxicosis, the sensations will not change.

Allocations at the stage of rejection usually begin, like menstruation - with a daub, which gradually "disperses", becomes more abundant. The color changes from brownish to scarlet, bright, cramping pains appear, blood clots appear in the discharge. Further flow takes place according to the scenario of a miscarriage.

How to distinguish from bleeding?

Menstrual blood is darker, resembling venous blood, while in most pathologies of pregnancy, the discharge is either brownish or scarlet - the color of arterial blood. Concomitant symptoms and changes in their own condition should alert the pregnant woman. Any discharge, even if it is not bloody, accompanied by pain, a feeling of heaviness in the abdomen, pulling back pain, a false desire to empty the intestines, is dangerous.

If the fact of pregnancy has already been proven by tests and examinations, bloody discharge should be treated exclusively as pathological. If even a slight “daub” appears, you need to consult a doctor, and in case of abundant sudden bleeding, call an ambulance and, while waiting for the brigade, take a horizontal position.

Statistics show that in 85% of cases, if a woman seeks medical help in a timely manner, pregnancy can be saved. The only exceptions are cases of frozen, ectopic pregnancy, miscarriage and cystic drift.

If the fact of pregnancy is not yet obvious and the bleeding began before the delay in menstruation or a few days after the delay, the best way to establish the truth is a pregnancy test. You can do it from the first day of the delay in menstruation. Before that, a blood test for hCG will come to the aid of a woman. If the diagnosis shows the presence of pregnancy, you should also consult a doctor with complaints of spotting.

It should be remembered that bloody menstrual discharge during pregnancy is not like regular menstruation - they are less abundant. You can also find several dozen differences in the woman's own feelings.

Are you worried about the problem: can there be periods during pregnancy? Let's see how this situation is possible, based on the physiological characteristics of the course of the menstrual cycle.

Let's try to learn to distinguish: where the norm ends and the pathology begins. Find out the possible sources of spotting at different stages of pregnancy.

Menstruation during pregnancy - abnormal or normal?

Recall the elementary knowledge from the school curriculum on human anatomy. The female reproductive organ - the uterus consists of three layers, starting with the outer:

• perimetry;
• myometrium;
• endometrium.

Each layer performs its own function.

1. The internal mucous membrane (endometrium) is formed in the first half of the cycle and is the most variable part of the organ;
2. During pregnancy, the endometrium thickens in order to preserve the fetus until the placenta matures;
3. When there is no pregnancy, the inner membrane is torn off and, together with blood and mucus, comes out.

If you are concerned about the question: can menstruation go during pregnancy, then by simple logical reasoning we come to the conclusion that if conception has occurred, then menstruation stops.

When a fetal egg is implanted in the endometrium, all layers of the uterus direct their forces to the preservation and further development of the embryo. Therefore, keep in mind that menstruation, in their usual sense, during gestation is always an anomaly, not the norm.

Of course, it also happens that you can not guess about your interesting situation up to 3 - 4 months, if your periods occur right on time. In this case, it is more correct to say about the individual moments of this phenomenon, and such an exception indicates a more or less complicated type of gestation.

Important! Bright, abundant blood is an alarming sign indicating an abortion. As a rule, a miscarriage begins quickly and abruptly, but if you act quickly, then there is a chance to save the pregnancy.

Normally, every woman, in her life, has several abortions. It's just that sometimes they happen at the smallest stage of pregnancy and everything looks like the onset of another menstruation.

We analyze the topic of a healthy pregnancy and proper behavior when planning a pregnancy in more detail on the Internet course I want a child! Preparing for the desired pregnancy >>>.

• You will learn how conception occurs and at what time it is most likely;
• What to do if pregnancy does not occur;
• How to behave in the first weeks of pregnancy to avoid problems with bearing

This is a course that will help you feel all the wisdom of your body and you will bear and give birth to a healthy baby without any problems!

normal course of the cycle

Under the menstrual cycle we mean the period from the first day of the next menstruation to the beginning of the next. Gynecology operates with average rates of blood loss, which are relative in nature, since they depend on:

1. genetic disposition;
2. the general health of the woman;
3. climatic region of residence;
4. age.

We observe the first bleeding at the age of 12-16 years. Depending on individual characteristics, deviations are possible, both up and down. It may take several months before a stable cycle with ovulation and the release of an egg is established.

Normal menses include:

• cycle length 21 - 35 days, on average 28 - 30;
• monthly deviations for 1 - 2 days;
• discharge period 3 - 7 days, optimally 3 - 5;
• the amount of blood from 50 to 150 ml per day.

These figures are most typical for women aged 25 to 35 years. During adolescence, the menstrual cycle can be up to 45 days. After 40 years, a decrease in length and regularity is characteristic, and the number of days of discharge increases. This situation is generally a variant of the norm.

Important! A monthly cycle of less than 20 or more than 45 days is not considered a good option and requires additional consultation with a gynecologist.

If you diagnosed menstruation prematurely, can there be pregnancy in this case? Modest menstruation earlier than the due day is one of the symptoms of the onset of conception.

Since the fetal egg, attaching to the mucous membrane of the uterus, can cause minor spotting. Cycle failure is also due to other reasons, including:

1. age;
2. colds, inflammation, infections;
3. changing of the living place;
4. stressful situations;
5. inappropriate contraceptives.

The regularity of the cycle is provided by a complex mechanism, based on the work of the hypothalamus, pituitary gland and ovaries, which secrete the necessary hormones (estrogen, progesterone). The reproductive health of a woman depends on them, with the normal course of the cycle.

What causes periods during pregnancy?

Consider the reasons why the body can start significant or not very spotting:

• an error in calculating the period when the last menstruation is considered pregnancy, although it occurred later (read the article on the topic: The first signs of pregnancy >>>);
• the process of attaching the fetal egg to the wall of the uterus;
• conception happened at the end of the cycle, when the menstrual phase was already running;
• a rare case: the maturation of two eggs, one of which was fertilized, and the other came out with the blood;
• trauma to the cervix during intercourse;
• hormonal disorders;
• risk of miscarriage;
• ectopic pregnancy;
• fading pregnancy.

Of all the reasons listed, only the last three have a real threat to the life and health of both the woman and the fetus. Especially, in case of heavy bleeding with pain, as in contractions. In such situations, immediately call an ambulance and try to observe bed rest.

Can menstruation go during pregnancy? Keep in mind that there are isolated unique cases when meager discharge accompanies the entire pregnancy - all this miracle is crowned with the birth of a healthy child. But such force majeure occurs extremely rarely, and even doctors cannot explain the nature of such a phenomenon.

Why is this condition dangerous?

In order for you to be able to independently assess the risks to the health, life of the baby and yourself, you need to control your well-being.

1. If you are in a good mood and appetite, there are no pains, then slight discharge does not pose a direct threat to pregnancy, but be sure to inform the gynecologist about them at the next turnout. In any case, you need to find out the cause and, if possible, eliminate the negative manifestations;
2. Are there periods during pregnancy due to hormonal disorders? Yes, it is possible if the body produces insufficient female progesterone and an excess of male androgen;

At the initial stage of gestation, this situation may not pose a danger to you, but, with an increase in the term, the risk of miscarriage increases.

Know! As a rule, such a problem is solved by taking hormonal drugs to maintain pregnancy. Do not try to self-administer such medications.

1. Perhaps the most serious danger is bleeding in the diagnosis: ectopic pregnancy;

The insidiousness of the pathology lies in the fact that at first there may be slight spotting and, it seems, there is no reason for concern. When the fetus reaches a critical size, the tube does not withstand and bursts. Therefore, delay in diagnosis and timely surgical operation is especially dangerous.

Periods at different stages of pregnancy

Based on female physiology, it is impossible to admit the presence of full menstruation during pregnancy. All single episodes go beyond the medical understanding of the process, do not find an explanation and are recognized as exceptions to the rules.

• Do periods come in early pregnancy? Theoretically, this is unlikely, but, in practice, you may encounter minor discharge at the initial stage of gestation, up to 12 weeks (read about the development of the baby and changes in the mother's body during this period in the article 1 trimester of pregnancy >>>);
• Bleeding in the later stages is fraught with serious consequences. Usually gynecologists, with any discharge and timing, will offer you hospitalization in order to find out the causes and save the pregnancy.

Statistics show that every fifth woman faces the problem of menstruation during pregnancy. Consider also that 80% of all miscarriages occur in the first 12 weeks. In this regard, it is completely unreasonable, even very dangerous, to treat lightly any secretions at the stage of gestation.

If you've heard stories like this, you might be under the impression that menstruation during pregnancy- a common thing, well, perhaps, a feature of the body. Actually it is not.
But after listening to the revelations of her friends, the young mother, discovering that she had , does not worry at all and is not in a hurry to be examined by a gynecologist.

The situation is further complicated by the presence of a fairly large number of "live examples" of this phenomenon. Moreover, mothers claim that with all this, the pregnancy proceeded normally, and the baby was born healthy.

Well, if so. This means that they are very lucky. After all, in fact, there are no periods during pregnancy and cannot be! This is a dangerous misconception that can lead to the loss of a child and complications with the health of the expectant mother.
Let's see what can cause this phenomenon and why it is so dangerous.

Menstruation during pregnancy: is it possible?

To begin with, let's refresh our knowledge of the anatomy and physiology of a woman.
As you know, once a month in the body of a woman, an egg matures, ready for conception. If fertilization does not occur, in due time it collapses. During this period, the uterus contracts and outward, in the form of spotting, comes out, in fact, what is left of the egg, as well as pieces of the endometrium - the tissue lining the walls of the uterus.

If the egg was fertilized, that is, pregnancy, as they say, on the face, then the essence of the ongoing processes changes significantly.
The body prepares a special place for the embryo and works hard to prevent the uterus from rejecting the embryo.

In particular, the female body begins to produce a special hormone - progesterone. This hormone has two main functions. Firstly, it stimulates the growth of the inner lining of the walls of the uterus (endometrium), so that the embryo can implant and better attach to them. Secondly, this hormone prevents the walls of the uterus from contracting, which protects the embryo from rejection.

I hope it is clear from here that they cannot go in any way. Well, if they do exist, what is the reason for this?

Why do periods occur during pregnancy

As already mentioned, spotting during pregnancy cannot be considered monthly. The cause of the discharge can be various pathologies, a violation of the hormonal functions of the mother's body. Such a phenomenon may be a signal of detachment of the fetal egg, which threatens a miscarriage.

Let's look at a few examples in more detail.

Often women who discover that they have menses during pregnancy actually suffer disruption of progesterone production. If this hormone is very small, then at the time set for normal menstruation, spotting with fragments of the endometrium can be observed.

This means that the uterus, as in the usual case, is cleansed, and at the same time it can reject the fetus. This, of course, cannot be allowed. Therefore, with timely treatment, the doctor prescribes to the expectant mother drugs that replace progesterone. In most cases, the threat of miscarriage with this type of disorder is stopped, and the mother calmly continues to bear the baby.

Also, the cause of the so-called menstruation during pregnancy can be abnormalities in the development of the fetus (genetic changes) or ectopic pregnancy.
It also happens that fruit does not attach well. For example, if the expectant mother suffers from endometriosis or has fibroids. Attached to such an unfavorable place, the embryo cannot develop normally, it is poorly supplied with oxygen, that is, a miscarriage may occur.

Another hormonal disorder leading to the appearance of spotting is hyperandrogenism. That is, to put it simply, an overabundance of male hormones. If untreated, this phenomenon often leads to detachment of the fetal egg, and, consequently, to a miscarriage.
With timely treatment, such consequences can be completely avoided.

Another rather rare phenomenon can be detected in those women who have menses during pregnancy.
It happens that initially 2 embryos are formed, that is, a multiple pregnancy. But at the same time, one of them develops normally, while the other is rejected by the body for some reason (unfortunate place of attachment, pathology, etc.). In this case menses during pregnancy are a signal of the process of rejection of one of the embryos.

As you can see, the reasons for such a phenomenon as menses during pregnancy far from harmless. Even worse consequences.
Therefore, do not listen to the advice of experienced people and do not close your eyes to what is happening. Even if you feel well, do not experience pain and discomfort, but you have spotting, do not hesitate to contact your doctor with a question why do periods occur during pregnancy.

And if lower back pain is added to the bloody discharge, something similar to contractions, the discharge becomes quite plentiful, immediately call an ambulance. It may turn out that an independent trip to the clinic will cost you a child!

As already mentioned, in many cases, especially if it is "hormones naughty", with timely access to a specialist, it is possible to avoid the threat of miscarriage. In other cases, even if nothing can be done, the sooner you inform the doctor that you have menstruation during pregnancy, the more chances to avoid health problems and hope for the next, more successful pregnancy.

Alexandra Panyutina
Women's magazine JustLady

If the release of blood occurs in a natural mode, without the manifestation of severe pain, brown blotches, a strong deterioration in well-being, they should not cause great concern, since this fact can be explainable and not dangerous to the fetus. Abundant periods in the first stages of pregnancy with acute pain in the lower pelvis, sacrum and lower back may indicate dangerous pathologies and the threat of losing a child.

In the earliest stages of pregnancy, menstruation may occur, while the woman may not yet be aware of her condition. If the pregnancy is confirmed (test, examination by a gynecologist, ultrasound), but menstruation still occurs, do not immediately panic and worry. Menstruation in the first month of pregnancy may be the norm in cases where they are not accompanied by additional negative symptoms.

If a woman is already aware of her condition, but at the same time she began menstruating during early pregnancy, it is better to play it safe and consult a gynecologist. If the menstruation is very heavy, it may be bleeding, so you do not have to wait for an appointment with the doctor, you need to call an ambulance as soon as possible. Menstruation during pregnancy in the early stages can be both the norm and a sign of pathology and the threat of miscarriage. Only a specialist can find out this by examining and conducting a special examination.

Why menstruation can go during early pregnancy

There are a number of reasons why bleeding may occur in early pregnancy:

• Menstruation in its usual form and mode with the onset of conception can go on for a physiological reason - a short period of time between the fertilization of the egg and the hormonal response of the body. Ovulation and the process of fertilization in a woman occurs in the middle of the menstrual cycle - 7-15 days. Often, the endocrine system of a woman does not have time to respond in a timely manner to the onset of conception.
• During pregnancy, there are periods due to hormonal imbalance, which should change immediately after conception. At the initial stage, a delay in the hormonal response to the onset of fertilization of the egg may be the norm. However, if during the development of pregnancy, the endocrine system does not produce enough progesterone, this can become a serious threat and cause interruption. If in the first month of pregnancy a woman begins to have bloody mucous discharge during the onset of menstruation, accompanied by general malaise and pain, you should consult a doctor. A clear picture of the state of the hormonal background of a woman can be determined after examination and examination.
• Mistakenly for menstruation, implantation blood discharge, provoked by damage to the endometrial vessels, can be taken. This does not happen in all women, so many do not even suspect such a phenomenon. Within 7-10 days after conception, the blastocyst (fertilized egg) moves down the fallopian tube to the uterine cavity. The embryo is implanted in the lining of the uterus (endometrium) in order to gain a foothold in it. This process causes swelling and irritation of the mucous membrane, violating the integrity of the capillaries of the walls of the uterus.
• Often, a failure occurs in the body, which leads to the release of two eggs at the same time. This often happens when taking medications that stimulate ovulation. When two eggs are released, one of them is fertilized and passes the natural path through the fallopian tube into the uterine cavity and is introduced into the endometrium, the second is rejected and comes out with menstrual blood. A similar situation can occur when the pregnancy is not properly developed by twins, when two eggs are fertilized. If one of the embryos dies, and the second turns out to be viable, bleeding can be taken for menstruation, removing a dead egg from the body.
• With congenital and acquired disorders and anomalies in the structure of the uterus, the menstrual cycle can continue, despite the onset of pregnancy. Congenital anomalies include anatomical abnormalities such as a unicornuate or bicornuate uterus. Acquired pathologies include benign tumor neoplasms (myoma, uterine fibromyoma, endometriosis). The maintenance and development of such a pregnancy depends on many factors. With a unicornuate and bicornuate uterus, there is a high probability of maintaining and successfully completing the birth of a pregnancy, but this requires close and constant monitoring by specialists.
• One of the most dangerous causes of menstruation during pregnancy is an ectopic pregnancy. When a fertilized egg moves down the fallopian tube, a disruption can occur due to which the embryo is embedded in the wall of the tube. Thus, instead of the uterine cavity, pregnancy begins to develop in the fallopian tube. Menstruation during an ectopic pregnancy can have a different character - from brownish bloody spotting to heavy bleeding. An ectopic pregnancy is extremely dangerous, it can end with a rupture of the tube, internal bleeding and subsequent inflammation. In this case, the help of a gynecologist is needed. The choice of treatment for ectopic pregnancy is determined by many individual factors. It is possible to save and remove the fallopian tube, but there is a risk of recurrence.
• Spontaneous abortion or miscarriage is also accompanied by profuse bleeding, similar to menstruation. A characteristic feature of a miscarriage will be periodic cramping pains and a bright scarlet color of the discharge. If a woman is aware of her pregnancy, an ambulance should be called. In clinical conditions, there is a possibility of maintaining pregnancy at the initial stage of bleeding.

How to distinguish menstruation during pregnancy from normal

Usually, a woman's menstruation follows a certain regimen - at first, the discharge comes out quite abundantly, then their number and frequency decreases. With bleeding caused by certain problems, the appearance, consistency, mode and duration of the discharge differs from menstruation. The nature of the differences depends on the causes, allocation:

• With a lack of progesterone, menstruation begins in the form of weak spotting, at the initial stage they are accompanied by not intense pain in the lower pelvis and groin. After a certain short time, the discharge intensifies to bleeding, the pains become more severe and cramping.
• With increased secretion of androgens (hyperandrogenism), spotting is accompanied by pulling pains in the lower pelvis and lower back.
• Implantation bleeding coincides with the onset of the next menstruation, but differs from menstruation by the scarcity of discharge.
• With an ectopic pregnancy, bleeding can begin immediately, very abundantly and very intensely. Even if at the beginning of the discharge they do not differ in large quantities, then soon the bleeding intensifies and is complemented by acute severe pain in the lower abdomen.

If a woman knows about her pregnancy, but at the same time noticed even small spotting on her underwear, you should immediately consult a doctor. The reason for menstruation during early pregnancy can be quite safe, but the possibility of a threatened abortion or its abnormal development can only be excluded with the help of an examination. Timely access to a specialist gives a chance to save the pregnancy.