Implantation bleeding

What is implantation bleeding?

Pregnancy begins with the fertilization of an egg that is still in the fallopian tube after ovulation. After fertilization, it migrates towards the uterus, divides and develops along the way and nests in the uterine lining.
This process can cause bleeding called implantation bleeding. It becomes medical Nidation bleeding called. It is a completely normal event that can occur in some women and does not cause harm to the mother or child.

When does implantation bleeding occur?

The female cycle begins on the first day of the menstrual period. Ovulation occurs about 14 days after the last period started. A mature egg jumps out of the ovary into the fallopian tube and can be fertilized there within the next 12 to 24 hours. If fertilization occurs during this period, the sperm and egg cells fuse.
The fertilized egg continues to develop and divide and is transported into the uterus by tiny cilia over the next five days. There it approaches the lining of the uterus.
About six days after fertilization, that is, six to seven days after ovulation, it attaches to the lining of the uterus and becomes embedded in it. This process is called nidation or Nidation called.
When implanting in the lining of the uterus, there may be a small amount of bleeding called implantation bleeding. So it occurs about five to ten days after the sexual intercourse that led to fertilization. This period generally corresponds to the 20th to 25th day of the cycle.

However, it happens that the small amount of blood first collects in the uterus and later drains away. Thus the day of implantation bleeding is postponed. For this reason, implantation bleeding can easily be confused with menstrual bleeding. Overall, implantation bleeding occurs in only a quarter of women.

Read also: The implantation of the egg cell

How does implantation bleeding feel?

Some women feel the implantation of the fertilized egg, others not. Both cases are quite normal and neither of them can be considered better or healthier.
If pain occurs during implantation, it often feels like a slight pulling or stabbing in the lower abdomen. Abdominal pain with cramps can also occur. Sometimes the implantation pain also radiates into the back.

Often the pain during implantation is very similar to the pain a woman feels during her menstrual period. In contrast, however, they usually last much shorter and are not as pronounced as the pain during periods. If the pain persists over a long period of time and is felt strongly, a doctor should be consulted for advice.

Read more on the subject at: Implantation pain

What can be signs of implantation bleeding?

There are several signs of implantation bleeding. Especially if the bleeding occurs between the 20th and 25th day after the beginning of the last menstrual period and it only lasts for a very short time, the probability that it is an implantation bleeding is increased. Even very light-colored blood suggests implantation bleeding.
Pain occurs rather rarely with implantation bleeding, whereas accompanying symptoms such as the first appearance of pregnancy sickness are more common.

Why does implantation bleeding occur?

During the cycle, the body prepares for a possible pregnancy. The lining of the uterus continues to grow, especially in the first half. With this structure, many blood vessels are formed that pull through the mucous membrane. As a result, the mucous membrane is very well supplied with blood and as soon as a fertilized ice cell is implanted, it can be supplied by the mother's blood.
During implantation, the fertilized egg penetrates the mucous membrane. To do this, the mucous membrane must be opened slightly so that the resulting child can embed itself completely. This opening can tear some of the numerous blood vessels in the uterine lining. This is how the implantation bleeding occurs.

In many women, however, it is so slight that no blood loss can be noticed with the naked eye. Of course, the cause of a bleeding can also be an early menstrual period or an intermenstrual period. Therefore, in the event of possible implantation bleeding, you should first wait for a pregnancy test to be able to speak of implantation bleeding with certainty.

What color is the blood with an implantation bleeding?

The fertilized egg implantation occurs in the second half of the cycle. By then, the lining of the uterus has built up and many new blood vessels have formed in it. Since this can tear minimally during implantation, it is fresh and therefore bright red blood that flows off.

However, it can happen that the blood collects in the uterus for a few days and only then drains away. If this is the case, it coagulates over time and the implantation bleeding is more of a brownish color.

Can tissue be present if there is an implantation bleeding?

The implantation bleeding occurs when the maturing embryo splits up the superficial part of the uterine lining and can thus lie inside the mucous membrane. During this process, the child's cells produce enzymes that dissolve the surface of the uterus structure. Usually the dissolved parts are so small that there are no visible pieces of tissue with the implantation bleeding.
In rare cases or when intermenstrual bleeding occurs at the same time, some tissue can be detached, which is then excreted with the blood.

Duration of implantation bleeding

The implantation bleeding time is usually very short. Most of the time, there is only one leak of blood or the bleeding lasts for a day. In a few cases, small amounts of blood may leak over several days.

Concomitant symptoms of implantation bleeding

Implantation bleeding can be accompanied by abdominal pain. These can feel like menstrual pain, but are usually short-lived and usually less severe. Another symptom of implantation can be a pulling in the breasts or a change in the nipples. Further symptoms only appear in the course of pregnancy. These include the typical pregnancy symptoms such as tiredness, vomiting, etc.

Abdominal pain and cramps

When a fertilized egg is implanted in the lining of the uterus, the mucous membrane is slightly damaged, which causes implantation bleeding.Like menstrual bleeding, this damage can manifest itself in the form of abdominal pain and cramps.

Since only a small part of the mucous membrane is affected by implantation bleeding and not the entire mucous membrane is shed off, as is the case with menstrual bleeding, the symptoms are generally less pronounced and last only one or a few days. If pain and cramps persist, you should see a doctor.

Read more on the topic: Lower abdominal pain during pregnancy

Back pain during implantation

The uterus is held in place by various ligaments in the woman's pelvis. These ligaments lead from the uterus to the abdominal wall on the one hand and to the back on the other. Discomfort in the area of ​​the uterus can cause it to contract or cramp. As a result, she simultaneously pulls on the ligaments that pull towards the back, which can cause back pain.
In the case of an implantation bleeding, the symptoms are usually too weak to affect the back. As the child grows larger as the pregnancy progresses, the ligaments tend to be pulled more often and thus back pain as well.

Treatment of implantation bleeding problems

Implantation bleeding and the pain it causes usually do not require treatment. However, if the pain does require treatment, it is important to make sure that some medications are not allowed to be taken during pregnancy as they can harm the child.

Pain medication such as ibuprofen should rather be avoided and, if at all, only be taken in the first trimester of pregnancy. Aspirin should also only be taken at the beginning of pregnancy. Paracetamol is therefore preferred for the treatment of pain during pregnancy.

If further or persistent symptoms occur, the therapy should always be discussed with a doctor, especially before taking medication.

Read more on the topic: Medication during pregnancy

How can you distinguish implantation bleeding from ovulation or intermenstrual bleeding?

It is often very difficult to distinguish implantation bleeding from ovulation or intermenstrual bleeding.
Intermenstrual bleeding can occur for various reasons, most of which lead to a hormone imbalance, which in turn triggers the bleeding. This can happen at any point in the cycle. The uterine lining has already built up during the intermenstrual bleeding, part of which is shed. As a result of the shedding, some of the blood coagulates and the bleeding is mostly brown and rather slimy. It is similar with ovulation. However, it occurs on the day of ovulation, around 14 days after the start of the last menstrual period.
Both bleeds last for one to three days and can vary in severity. In contrast, with implantation bleeding, vessels of the uterine lining are directly injured. Usually no mucous membrane is peeled off. Therefore, the implantation bleeding is usually bright red and more fluid. It occurs more at the end of the cycle, i.e. on the 20th to 25th day of the cycle, and often only lasts for one day.
However, it is important to know that the blood that is created by the implantation can in some cases remain in the uterus for a few days before it flows away. It coagulates and turns brown. In addition, the point in time is shifted further back.

Read more on the subject at: Spotting

Can you have implantation bleeding despite the pill?

The pill regulates a woman's cycle and menstrual flow. Even when taking the pill, the lining of the uterus builds up every month. During the days on which no pill is taken, the mucous membrane is shed, as in the cycle of a woman without hormones, and menstruation occurs.

Mistakes in taking or forgetting to take the pill can make a woman pregnant despite continued use. This means that after fertilization, the egg cell also nests.
Since a high mucous membrane that is well supplied with blood has already built up when taking the pill, you can have implantation bleeding despite the pill. In general, however, the following menstrual period does not occur despite taking the pill off. If this is the case, a pregnancy test can confirm whether the previous bleeding was an implantation bleeding.

Does an ectopic pregnancy also lead to implantation bleeding?

The implantation bleeding is caused by the superficial opening of the uterine lining, which is well supplied with blood. Since there is no highly built-up mucous membrane in the fallopian tube, not so many blood vessels can be opened in an ectopic pregnancy and there is usually no implantation bleeding.

In some cases, minor injuries to the fallopian tube can lead to bleeding. In addition, hormonal changes can lead to bleeding in an ectopic pregnancy, which can be mistaken for implantation bleeding.

Read more on the subject at: Ectopic pregnancy

Can I still take the morning-after pill after an implantation bleeding?

The morning-after pill works mainly by suppressing ovulation by taking certain hormones.
According to the current state of research, it does not prevent the implantation of an already fertilized egg cell. In addition, it does not lead to the termination of an existing pregnancy. Pregnancy occurs when the man's sperm fertilizes the female egg within the first 12 to 24 hours after ovulation. Since sperm can survive in the uterus for up to five days, you can get pregnant with sexual intercourse in a period of five days before ovulation and one day after.

Since the morning-after pill only prevents ovulation, it only protects against pregnancy if the egg has already been released from the iron stick. This has already happened at the time of the implantation bleeding. In addition, it takes six days from fertilization to implantation. Since the morning-after pill only works optimally in the first 72 hours, i.e. in the first three days after sexual intercourse, it can no longer be taken after the implantation bleeding to prevent pregnancy.

Read more on the subject at: Morning-after pill