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First period after expectant management?

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lolly2481
Posts: 38
Joined: Wed Dec 23, 2020 8:33 pm

First period after expectant management?

Post by lolly2481 »

Hi, on the 9th of December I was diagnosed with an ectopic pregnancy. I had gone to the hospital due to bleeding which started at 5 weeks pregnant. It wasn't particularly heavy and there weren't lots of clots or tissue so the doctor was surprised it was ectopic as I had no other symptoms. My hCG levels at that first blood test were 189 and eventually dropped to 29 almost 3 weeks ago. The hospital said to do a HPT 3vweeks later which would be tomorrow. This morning I have started with some bleeding. Does anyone know if this is my first period or just because my hCG levels have reached 0? I'm unsure if the bleeding i had originally could have been because hCG levels were dropping? I am going to leave it until after my next period (theoretically in February) to try again but just wondered..
Thanks
Lolly x

EPT Host 20
Posts: 3155
Joined: Thu May 31, 2012 10:58 pm

Re: First period after expectant management?

Post by EPT Host 20 »

Dear Lolly,
I am so sorry to hear of your ectopic pregnancy and loss,
To answer your question, the first bleed that occurs after ectopic pregnancy is not classed as a period. It is the body's response to falling hormone levels because you are sadly no longer pregnant. This process involves vaginal bleeding - it can be clotty or like one of your usual periods and some women have bleeding/spotting for up to six weeks. Most women find that their period arrived around four weeks after their hCG levels have fallen to 0.

As a gentle reminder regarding conceiving again, we and many medical professionals advise waiting for two menstrual cycles. It is important to allow time for your body to recover and emotions to surface and be worked through. This is so that you have some comfort that your body is returning to its natural rhythm and you have a last menstrual period date from which to date a new pregnancy - key information in checking you are not suffering from an ectopic pregnancy in the future. This first bleed soon after ectopic pregnancy is not classed as a period as it is the body's response to falling hormone levels.

Sending much love,
Karen x


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Cs1
Posts: 1
Joined: Sat Jan 23, 2021 2:18 pm

Re: First period after expectant management?

Post by Cs1 »

Hi,
I just wanted to post a reply as it sounds as if you are going through something similar to what I have just been through. I was diagnosed with an ectopic back in late September/ October. My levels finally came back down at the beginning of November after 6 weeks of bleeding and blood tests. On the day they rang me to tell me my levels were back to normal (I had stopped bleeding by this point) I then started to bleed again with what looked like a period but lasted 12 days. I assume this was a result of the falling hormones. A normal cycle later with a positive ovulation test, I had a normal period and have since had normal cycles. I was amazed how quickly my body bounced back in to normal cycles, a womens body is an incredible thing! Hope all goes well for you in the future!

lolly2481
Posts: 38
Joined: Wed Dec 23, 2020 8:33 pm

Re: First period after expectant management?

Post by lolly2481 »

Hi, thanks for replying Cs1. The bleed i just had lasted exactly as long as my period normally would: 5 days so still not sure whether it was a period or a hCG drop bleed. Whatever it was it can only be a good thing and a step in the right direction of getting back to a normal cycle. I'm tracking BBT and will do OPKs to try to see if i will ovulate this month. What will be will be, I guess :)

Tron
Posts: 8
Joined: Sat Jan 20, 2024 12:35 am

Re: First period after expectant management?

Post by Tron »

I am also having a second bleed before (or perhaps right as) my hcg drops to 0. I had the big bleed the week of the methotrexate injection. I am having a second bleed now at 4 weeks post methotrexate injection. It is bright red, heavy, clots, but no increase in pain or symptoms to indicate a rupture. My HCG was at 50 last week when they checked but they are checking again today to see if it is low enough that I may be on my period. There is very little information out there about how low an HCG may need to be to have a period, but hopefully that is what is happening to me too.

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