What is implantation bleeding and how can I recognize it?
When a fertilized oocyte implants in the wall of the uterus, something that normally happens around days 8 to 12 from conception, it can sometimes cause some type of erosion of the uterine tissue which can later 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 implantation of the embryo, it 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, can cause the fertilized egg implantation process itself to produce a wound that releases blood into the uterus. This blood is expelled by 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 did a test at this time, it would very possibly come out negative because you would be at a very early stage of embryo implantation.
It does not happen always or to all women, approximately in 3 out of 10 pregnancies. On the other hand, when it happens, it can generate some concern in those who are looking forward to a positive. Unfortunately it's not easy differentiate implantation bleeding from bleeding between cycles, also called spotting, from the start of menstrual bleeding, or from 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 when 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 going on.
Let's see what clues can help us Differentiate implantation bleeding from menstrual bleeding:
Color of implantation bleeding:
Implantation bleeding is usually more pinkish or brownish while menstrual bleeding is usually light pink or straight brown, which also changes quickly to deep red.
Flow intensity when there is implantation bleeding:
Implantation bleeding is normally very light spotting. In contrast, menstrual bleeding usually starts out light but soon becomes heavier.
Inconvenience during embryo implantation:
The discomfort in the lower abdomen that accompanies implantation bleeding are usually milder and shorter than those of menstrual bleeding, which are usually stronger and last longer in time. While it is true that each woman has a typical pain threshold in her cycles and should be able to set the intensity based on what is usual or not in 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 some pink "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. At the end of the brief bleeding, in case of pregnancy other symptoms such as pressure in the chest, nausea or digestive discomfort can begin or continue, while, in case of menstrual bleeding, when the period comes down, all 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, it is something normal for her.
Consistency of implantation bleeding:
Implantation bleeding can come and go for a couple of days. In case it is a more constant and consistent bleeding and tending to increase, it is more likely it is a menstrual bleed and not a pregnancy.
There are other conditions for which there may be some type of bleeding related to pregnancy so, in case you believe you can 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 need medical intervention with some urgency.
When there is pregnancy and there is bleeding
On the contrary, in case more than 10-14 days have passed since conception or even with the 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 debris that is being altered due to pregnancy and can be dislodged.
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 irregular cycles or cycles that 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 quickly decreases to an intense color, without clots and, if possible, during the day and not in the evening. A regulated cycle favors fertility and it is relatively easy to correct. And, in addition, it will allow us to differentiate more clearly any symptom of pregnancy or implantation bleeding.
It may interest you:
References:
- Vaginal bleeding in very early pregnancy. EW Harville, AJ Wilcox, DD Baird, CR Weinberg
- Human Reproduction, Volume 18, Issue 9, September 2003, Pages 1944–1947
- Martonffy AIet al. First trimester complications. Prim Care Clin Office Pract. 2012; 39: 71-82
- Vaginal bleeding during early pregnancy – gynecology and obstetrics. (nd). 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. Terile fertile. nineteen ninety six; 1996: 65-1093
- 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 practise. 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