What is implantation bleeding and how can I recognize it?
When a fertilized oocyte implants in the wall of the uterus, something that usually happens around days 8 to 12 from conception, it can sometimes cause some type of erosion of uterine tissue which can then be expelled through the vagina in the form of a light bloody stain. This light bleeding is known as implantation bleeding and is not menstruation.
Thus, if there has been embryo implantation, this occurs a few days after fertilization or embryo transfer (in cases of assisted reproduction). This interaction between the embryo and the woman's endometrium, which is full of blood vessels, It can cause the implantation process of the fertilized egg to produce a wound that releases blood into the uterus.. This blood is expelled through implantation bleeding at a time in the cycle when we did not expect to have any type of spotting. All this happens days before we can do a pregnancy test. In fact, if you took a test at this time, it would most likely come out negative because you would be at a very early stage of embryo implantation.
It does not always happen or to all women, approximately in 3 out of every 10 pregnancies. On the other hand, when it happens, it can generate some concern in those who are wishing for a positive result. Unfortunately, it is not simple differentiate implantation bleeding bleeding between cycles, also called spotting, the beginning of menstrual bleeding or some other type of bleeding.
Without a doubt, the best way to confirm it is through a pregnancy test, but there are times when it is still early or we want to wait for the beta result... In those cases, there are some signs that can give us clues to know what is really happening.
Let's see what clues can help us Differentiate implantation bleeding from menstrual bleeding:
The color of implantation bleeding:
Implantation bleeding is usually more pinkish or brown, while menstrual bleeding is usually light pink or directly brown, which also quickly changes to intense red.
Flow intensity when there is implantation bleeding:
Implantation bleeding is usually very light spotting. On the other hand, the bleeding corresponding to menstruation usually begins lightly but then becomes heavier.
Inconvenience during embryo implantation:
The discomfort in the lower abdomen that accompanies implantation bleeding is normally milder and briefer than that of menstrual bleeding, which tends to be stronger and last longer. Although it is true that each woman has a normal pain threshold in her cycles and should be able to establish the intensity based on what is or is not usual for her.
Clots during embryo implantation:
Clots are practically exclusive to menstrual bleeding. In fact, if there had been implantation, the presence of clots would not be good news. Another thing is that during implantation bleeding, pinkish "threads" occur, but these are not clots. If this is what you have observed, it would be ideal to do a ultra early pregnancy test In a few days.
Duration of implantation bleeding:
Implantation bleeding usually lasts less, between one and three days, while the onset of menstrual bleeding can last up to 4 or 7 days, depending on the case. Once the brief bleeding has ended, in the case of pregnancy, other symptoms such as pressure in the chest, nausea or digestive discomfort may begin or persist, while, in the case of menstrual bleeding, when the period begins, all of these symptoms – which can also be common – have to dissapear.
Again, each woman has a tendency to menstruate in a certain way and can assess whether it is unusual bleeding or, on the contrary, something normal for her.
Consistency of implantation bleeding:
Implantation bleeding may come and go for a couple of days. If the bleeding is more constant and consistent and tends to increase, it is most likely menstrual bleeding and not from a pregnancy.
There are other conditions that may cause some type of bleeding related to pregnancy, so if you believe you may be pregnant, any type of bleeding should be taken into account and should be reported to the doctor.
They are the least of the cases but it could have to do with an ectopic pregnancy, that is, outside its natural site, which is the uterus. And this is a condition that would require medical intervention with some urgency.
When there is pregnancy and there is bleeding
On the contrary, if more than 10-14 days have passed since conception or even with a positive pregnancy test, it is not uncommon for pregnant women to have some type of blood loss during the first trimester of pregnancy: from internal clots to tissue remains that are being altered due to pregnancy and can become detached.
When a woman is regular in her cycles and they develop as physiologically normal, the symptoms listed They are easier to identify. If, on the other hand, the woman usually has cycles that are irregular or start very slowly or there is a habitual tendency to spotting, these symptoms may not be as clear and it may be much more difficult to identify implantation bleeding.
From here, we would like to take the opportunity to insist that, ideally, women's bleeding should be with little or no pain, that it should quickly go down to an intense color, without clots and, if possible, during the day and not at night. A regulated cycle promotes fertility and it is relatively easy to correct. And, furthermore, it will allow us to more clearly differentiate any symptoms of pregnancy or implantation bleeding.
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References:
- Vaginal bleeding in very early pregnancy. E.W. Harville, A.J. Wilcox, D.D. Baird, C.R. Weinberg
- Human Reproduction, Volume 18, Issue 9, September 2003, Pages 1944–1947
- Martonffy AI et al. First trimester complications. Prim Care Clin Office Practice. 2012; 39:71-82
- Vaginal bleeding during early pregnancy – gynecology and obstetrics. (n.d.). Retrieved March 27, 2018 from https://www.msdmanuals.com/professional/gynecology-and-obstetrics/symptoms-during-pregnancy/vaginal-bleeding-during-early-pregnancy
- Ankum WM et al .W. Risk factors for ectopic pregnancy: a meta-analysis. Fertile terile. nineteen ninety six; 65:1093-1099
- Coppola PT et al. Vaginal bleeding in the first 20 weeks of pregnancy. Emerg Med Clin North Am. 2003; 21:667-677
- Niebyl JR Clinical practice. Nausea and vomiting in pregnancy. N Engl J Med. 2010; 363:1544-1550
- Tan PC et al. Contemporary approaches to hyperemesis during pregnancy. Curr Opin Obstet Gynecol. 2011; 23:87-93
