Implantation bleeding, what you need to know.

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Implantation bleeding: What it is and why it occurs

Many women who are trying to conceive have experienced the so-called implantation bleeding, more commonly known as “spotting.” These occur shortly after the fertilized egg implants and sometimes cause some concern for the mother, even though it is a completely normal phenomenon.

Have you ever experienced implantation bleeding? If you are worried that your pregnancy may be at risk due to some bleeding after fertilization, continue reading to understand what it is and how it affects the successful implantation of the egg.



Implantation bleeding: What is it?

Let’s start by understanding what implantation bleeding is and when it occurs. It refers to small bleeding episodes that happen after sexual intercourse, typically between the eighth and tenth day after the egg has been fertilized. Essentially, the so-called spotting occurs right after the beginning of pregnancy and is a discharge that replaces menstruation on the days when it would normally occur if there were no ongoing pregnancy.

This is why many women think they are not pregnant and still experience menstrual cycles, even though, as we will see later, these bleedings have nothing to do with menstruation. From a scientific perspective, the bleeding that occurs approximately ten days after sexual intercourse is actually the egg implanting into the endometrium. The endometrium is the tissue that lines the uterus, specifically its inner wall. Its purpose is to serve as a “mattress” for the embryo to be received inside the woman’s body.

The endometrium becomes “spongy” when the woman welcomes the egg, in order to better protect the embryo. Often, when spotting occurs, the woman does not yet know she is pregnant and confuses this phenomenon with the onset of menstruation.

We can therefore affirm that the origin of implantation bleeding is completely benign and entirely physiological. Although many new mothers get scared – especially those actively trying to conceive – it is a completely natural process of the egg being fertilized inside the uterus.

It occurs due to the lesion caused in the local blood vessels, a mechanism that creates bleeding and therefore a small hemorrhage, which is essentially the blood that flows into the uterine cavity as it is not absorbed by the endometrium. There is no need to be afraid of implantation bleeding, and even though it may cause concern at first, it is a true symptom of pregnancy. As many gynecologists state, bleeding is quite common and affects about 3 out of 10 women, a very high percentage.


Causes of implantation bleeding

What are the causes of this bleeding? As we have seen, implantation bleeding is a natural phenomenon that affects many women worldwide. However, sometimes many women worry about a potential spontaneous miscarriage, especially if they have had previous unsuccessful pregnancies. Knowing the causes of this normal bleeding that occurs some time after sexual intercourse can reassure those who experience this phenomenon, especially if it happens a few days after conception.

These small bleedings are caused by the rupture of uterine blood vessels, as the egg creates adhesion with the endometrium, which in turn causes slight bleeding. Moreover, when these bleeds are heavier, they can easily be confused with menstruation because the uterine blood is often mixed with the blood from the previous menstrual flow.

It should also be noted that when a pregnancy begins, natural transformations of the cervix and the structure of the organs involved in conception also occur. In this case, the tissue changes create minor traumas that can lead to bleeding. It only happens in rare cases that spotting occurs due to detachment of embryonic cells, which fail to enter the so-called uterine mucosa to receive the necessary nourishment.


Symptoms of implantation bleeding

The symptoms and signs of implantation bleeding are generally quite clear, although they can sometimes be confused with those of menstruation, which can vary in color and quantity each month. However, among the indicators of pregnancy, it is very common to experience a slight sense of nausea and cramps in the days following implantation. In this case, many women also experience the so-called spotting, which indicates that the egg has successfully implanted inside the uterus.

It is important to note that pregnancy symptoms can overlap with those of menstruation and menstrual cycle disturbances, such as nausea, fatigue, frequent urination, hormonal cravings, and sensitive and tender breasts. This natural process in the female body also presents a series of symptoms that, for the majority of individuals, indicate the occurrence of pregnancy. Along with physical symptoms such as small rosy blood loss and cramps in the lower abdomen, hormonal fluctuations due to estrogen can also cause significant mood swings, anxiety, and sadness.

One of the most common symptoms that indicate the successful implantation of the embryo is, in fact, the subject of this article: implantation bleeding (or spotting), especially when it occurs between 8 to 10 days after sexual intercourse.


Recognizing implantation bleeding

Although it may seem straightforward, recognizing implantation bleeding is not always easy. As we mentioned earlier, it is possible that the bleeding is a combination of old menstruation caused by the uterus clearing itself from the blood of the previous month and the typical spotting of pregnancy. According to experts at a Cleveland Clinic, typical implantation bleeding has a brownish color and consists of small drops of blood, unlike menstruation, which is usually more abundant.

The menstrual flow is, therefore, quite different, although many patients consult their gynecologist believing they have ovulated twice in one month. However, that is not the case. It is important to note that when there is implantation bleeding, the loss is lighter and resolves very quickly. Of course, it is always better to evaluate each symptom together with your healthcare provider to exclude any other issues and the rare possibility of a threatened miscarriage.

One of the most common situations is undergoing an ultrasound and discovering that you became pregnant a month earlier than planned, especially if there is a total absence of cramps associated with the bleeding and if the implantation bleeding has been rather abundant.

In summary, this type of bleeding can be distinguished from the menstrual cycle by its color and duration. Generally, it is light and does not last more than a few days. However, it is important to keep in mind that each individual is different, especially regarding hormonal fluctuations that affect each woman differently.

In most cases, these bleeds do not last more than two days and are often barely noticeable. Many women actually wait for their menstrual cycle, thinking they are experiencing simple ovulatory spotting while waiting for the actual flow. Yet, one of the elements that allows us to distinguish implantation bleeding from menstruation is the color. When monthly bleeding occurs, there are variations in the tone of the blood, characterized by bright red or dark colors for older blood, gradually becoming less intense over the course of several days.

Implantation spotting, on the other hand, is usually rosy and sometimes whitish, although it can occasionally have a brownish hue. In this case, similar to menstruation, the color and tone provide information about the timing of egg implantation: if the bleeding is light, it indicates a very recent pregnancy. For the sake of completeness, we also specify that the absence of menstruation is not synonymous with pregnancy.

Sometimes, bleeding can also be an indicator of infections or irritations of the cervix, which are common after sexual intercourse or a thorough gynecological examination.


Duration of implantation bleeding

The duration of implantation bleeding varies from individual to individual. Typically, it lasts for a few days, but there are cases where patients have experienced this phenomenon for several weeks. If it persists for a long time, it is best to undergo a thorough evaluation to exclude any other underlying conditions. Bleeding during pregnancy can be very distressing for women, as they fear the risk of miscarriage.

It is generally recommended to immediately contact the gynecologist if there are traces of blood and if the bleeding persists for too long. Another important precaution during this delicate period is to avoid using internal tampons to prevent infections and avoid endangering the life of the embryo.

It is important not to confuse implantation bleeding with bleeding caused by infections, such as urinary tract infections, which often cause minor bleeding in the urinary tract. Additionally, although normal sexual intercourse does not pose a risk to women during pregnancy, it is advisable to abstain if bleeding occurs until receiving approval from the gynecologist.

Furthermore, these hemorrhages do not occur in all pregnancies. As we mentioned earlier, many women do not experience any symptoms when they become pregnant. The presence or absence of implantation bleeding does not help in recognizing pregnancy, but it is important to consult a gynecologist who can determine the cause. In short, this phenomenon is individual and occurs differently based on a woman’s health condition and ovulation timing.

Not always is the blood flow light; it is possible to have a combination of blood and vaginal mucus, making the bleeding more abundant. One of the most common questions women ask when trying to conceive is about the abundance of these bleeds, especially to differentiate them from normal menstrual flow. It is important to note that a pregnancy test alone is not enough to provide reassurance, but in the absence of a menstrual cycle and the occurrence of spotting, it is advisable to determine the cause with a medical expert as soon as possible.


When to seek medical attention

As one can easily imagine, pregnancy is a very delicate period for every woman. Therefore, especially in the first trimester, it is common for women to be concerned about the health of the embryo and the successful progression of the pregnancy. As many gynecologists state during the initial check-up visits, it is possible to have small vaginal secretions during the early stages, which should not cause concern, especially if regular medical check-ups are being conducted.

Experts agree in reassuring new mothers regarding vaginal discharge, which is harmless when it is transparent or whitish. On the other hand, discharge that tends towards green or yellow or has a thick white consistency should raise concerns. If the discharge is foul-smelling and abundant, it is important to contact the gynecologist as soon as possible, as it could indicate a vaginal infection that requires a swab test to determine its nature and proceed with the appropriate treatment.

The only bleeding that raises concerns during pregnancy occurs in the second and third trimesters, the two months when placental abruption may occur, posing a worrying threat of miscarriage. If the bleeding occurs before the 37th week, it may indicate a premature birth and premature labor with contractions exceeding the normal physiological frequency.

For this reason, many doctors recommend regular check-ups to exclude any potential issues, especially if abnormal bleeding is among the symptoms. The pregnancy guidelines state that it is necessary to consult a gynecologist whenever there is bleeding outside of the menstrual cycle. This applies to all women, even those who are not trying to conceive. The first advice is, therefore, to avoid self-diagnosis and seek medical attention for tests and examinations recommended by the specialist. Bleeding outside of menstruation can be normal in the majority of cases, but there is a possibility that it may be due to an infection or an underlying condition.

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