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Menstruation in early pregnancy
Medical expert of the article
Last reviewed: 05.07.2025
One of the most common questions from pregnant women is: "Can there be periods in early pregnancy?" To answer this question, we will first try to explain the physiology of menstrual flow in an accessible way.
The menstrual cycle is individual for each woman and can be from 19 to 45 days long, and all this is relatively normal. We will consider the onset of pregnancy in the "classic" version, with a cycle duration of 28 days. The first day of menstruation is considered to be the first day of bloody discharge from the vagina. When they end, the female body begins to produce estrogens, which affect the growth of the inner wall of the vagina - the endometrium. This process lasts approximately half a cycle and at its peak, ovulation occurs (the release of an egg from the ovarian follicle). After ovulation, the second phase of the menstrual cycle begins, called the luteal phase. In this phase, the female hormone - progesterone rules, which prepares the endometrium for the attachment of the fertilized egg, while loosening it. If fertilization has occurred, the egg is immersed in the soft walls of the inner layer of the uterus and begins to actively develop. If the fusion of the egg and sperm does not take place, the female body begins to prepare the reproductive organs for a new cycle. The inner layers of the uterus begin to be rejected, while small capillaries rupture and bloody discharge comes out along with the old endometrium, which is called menstruation.
Based on the physiology of menstruation, the logical conclusion is that there can be no menstrual flow when pregnancy occurs. Is this really true? And what to do if your period starts early in pregnancy? We will answer your questions below.
[ Causes of periods in early pregnancy
There is a popular concept called "washing the fetus". It is claimed that menstruation can occur in the early stages of pregnancy. This is true, but it is more an exception to the rule than a rule, so below we will provide a list of the most common reasons for menstruation in the early stages of pregnancy.
The main and most common reason for the appearance of menstruation in the early stages of pregnancy is a hormonal imbalance. Most often, there is a deficiency of progesterone - the pregnancy hormone responsible for the growth and development of the endometrium. A rarer case is an increased amount of androgens - male hormones. In both cases, the cause is quite easy to find out and it is just as easy to correct the level of hormones with the help of special drugs.
An ectopic pregnancy is also a cause of menstruation in the early stages of pregnancy. In this case, painful sensations often occur in the area of the uterus and fallopian tubes. An ectopic pregnancy is very dangerous and can only be detected by ultrasound. Most often, with an ectopic pregnancy, the fetus attaches to the fallopian tube and, developing, can cause its rupture.
Placenta previa can also cause bleeding. If the placenta is attached low and partially or completely covers the cervix, there is a high probability of bleeding after physical exertion. The placenta attachment site can also be determined by ultrasound examination.
Heavy physical exertion or stress can also cause menstruation in the early stages of pregnancy. Physical exertion may cause uterine tone, which may lead to placental abruption. Stress may cause hormonal imbalance, which may also lead to miscarriage.
Endometriosis or myomatosis is the proliferation of the endometrial walls, resulting in areas that are poorly supplied with blood. If the fetus is attached to the area of the endometriosis focus or to the myomatous node, it may be spontaneously rejected.
Frozen pregnancy. There are cases when, due to genetic disorders of the fetus or other abnormalities, the pregnancy freezes. Then a spontaneous miscarriage occurs, which usually begins with bloody discharge similar to menstruation.
Who to contact?
What to do during menstruation in early pregnancy?
The most important thing to remember is that menstruation in early pregnancy is not normal. Most gynecologists call bloody discharge a threat of miscarriage. Therefore, if you find them in yourself, you need to urgently contact your gynecologist or call an ambulance. The doctor will do an ultrasound and then decide whether you need to go to hospital for preservation and what medications to take.
In case of hormonal disorders due to insufficient production of progesterone, drugs containing this hormone are prescribed. The most common of them are Duphaston and Utrozhestan. The dosage is selected individually by the attending physician. When canceling progesterone-containing drugs, it is important to remember that the dosage should be reduced gradually, since abrupt withdrawal of the drug can lead to a miscarriage.
In case of hyperandrogenism, a drug blocking the production of androgens is used. Such drugs include metipred and dexamethasone. The dosage is also selected individually after assessing the results of the hormone analysis.
In case of an ectopic pregnancy, unfortunately, there is only one way out - termination, since a growing fetus outside the uterus can lead to the death of the mother. The operation is usually performed under general anesthesia by laparoscopy or abdominal surgery. In this case, the fallopian tube can be either removed or preserved (if possible).
In case of placenta previa, complete sexual rest and no physical activity are prescribed. If the situation requires hospitalization, the pregnant woman is sent to the hospital for preservation. Usually, a low placenta is not a death sentence. As the fetus grows, the placenta tends to rise.
During menstruation in the early stages of pregnancy due to stress and physical exertion, the woman is sent to the hospital to maintain the pregnancy. For this purpose, hemostatic drugs (for example, tranexam), antispasmodics (no-shpa, papaverine) and sedatives (valerian, motherwort) are prescribed.
If a spontaneous miscarriage has begun, as a result of a frozen pregnancy, nothing needs to be done. Unfortunately, the pregnancy did not take place.
What can be done during menstruation in the early stages of pregnancy before the ambulance arrives? The very first thing is to lie down and not strain. If there is a nagging pain in the lower abdomen, then you need to insert a papaverine suppository into the rectum and take one No-shpa tablet. You must take the pregnant woman's exchange card with you to the hospital.