Will I be pregnant, doctor? Is it.. implantation bleeding or menstruation?
This is a question that might happen to many people, but they may not know, causing the problem to be solved slowly.
Question: Doctor, my period usually comes on the 30th, but yesterday it was black blood, and on the 1st it stopped. Am I pregnant?
Answer: Yesterday was the 29th, and you had bleeding for only 2 days. The color was so dark it looked black, and the bleeding stopped quickly. Based on the history, “there is a possibility of being pregnant.” It might be “implantation bleeding.” Let’s continue to listen to what it means, how it happens, how it differs from menstruation, and how to confirm it.
What people commonly call “implantation bleeding”, in medical terms, is known as “Implantation bleeding.” It is the blood that comes from the implantation of the embryo in the uterine cavity. Women with regular menstrual cycles every 28 days will ovulate around the 14th day of the cycle (counting from the first day of menstruation). When having intercourse, the egg is fertilized by the sperm, and fertilization occurs in the fallopian tube, which happens within 12-24 hours after ovulation. After that, the fertilized egg (Zygote) continues to develop into an embryo (Blastocyst) and travels to the uterus to implant in the uterine lining. This implantation can sometimes cause small blood vessels in the uterine wall to break, leading to bleeding through the vagina, which occurs about 6-12 days after ovulation. Menstruation occurs 14 days after ovulation. These two events, menstruation and implantation bleeding, occur around the same time, causing confusion.
Observing accompanying symptoms would be beneficial.
The first sign of pregnancy that is easiest to notice is breast tenderness or swelling.
Implantation bleeding occurs in about 1 in 3 pregnancies or only 30%. Women who are pregnant for the first time are more likely to have implantation bleeding than in subsequent pregnancies because the embryo has implanted before. Implantation bleeding differs from menstrual blood, allowing for some differentiation in 4 noticeable ways:
- Duration of bleeding: Implantation bleeding flows through the vagina about 6-12 days or an average of 9 days after ovulation, which means implantation bleeding comes earlier than menstruation, occurring 1 week to a few days before the expected period. The closer the bleeding is to the expected period date, the less likely it is to be implantation bleeding.
- Characteristics of the blood: Implantation bleeding is minimal, spotting, or just a drop, staining the underwear. Some may not feel or notice it, and it stops on its own.
Menstrual blood, on the other hand, is much heavier. - Blood color: Implantation bleeding is pale pink, not bright red, and turns dark brown or rust-like brownish-red or black. Sometimes it may be bright red. Menstrual blood is bright red or dark red.
- Duration of bleeding: Implantation bleeding lasts only 1 or 2 days, while menstruation lasts 3-5 days but not more than 7 days.
There are other accompanying symptoms to note during implantation bleeding:
1. Mild cramping in the lower abdomen due to uterine contractions, which is normal, indicating possible pregnancy. Therefore, when experiencing lower abdominal cramps, women should ask themselves, “Am I pregnant?”
2. During implantation bleeding, women often have mood swings and may experience headaches.
From this question, spotting on the day close to the expected period for only 1 day can be confusing. Therefore, it is necessary to take a urine test to check for pregnancy.
From the topic of implantation bleeding, the doctor has the following important recommendations:
1. Do not mistakenly think that slight bleeding before the period is just a light period, as it can lead to errors in pregnancy and gestational age.
2. Implantation bleeding indicates pregnancy, which is normal and does not require treatment, but women can also be pregnant without implantation bleeding.
3. The timing of implantation bleeding is during the embryo’s implantation in the uterine wall, about 9-10 days after ovulation or fertilization, which is within 6-12 days after ovulation.
4. After implantation with bleeding for about 3-4 days, a blood test can be done to confirm pregnancy, or a urine test can show a positive result about 5-6 days after that.
Therefore, women who are unsure whether it is menstruation or implantation bleeding should wait about 1 week after the first day of bleeding to take a urine test for a more accurate pregnancy result.
With love and care,
Doctor Ruangkit Sirikanchanakul