Implantation Bleeding

The procedure of implantation starts right after fertilisation when the fertilised egg called embryo starts travelling down the fallopian tube to reach the uterus so that it can attach itself to the uterine wall. While traversing down the fallopian tube, the embryo starts multiplying and forms a bunch of cells which is called Blastocyst. The Blastocyst will look for a favourable position in the uterine wall so that it can attach itself and derive nutrition for the next nine months.
Implantation Bleeding
Implantation Bleeding

What is Implantation Bleeding?

Implantation bleeding is the pink or brown colour discharge that happens when the embryo goes and implants itself in the uterine lining after 6-12 days of conception. As the embryo starts growing, it starts initiating a connection with the uterine lining to get blood supply to derive nutrients from the maternal circulation. Due to the movement of the egg in this region, some blood vessels may break, which can result in bleeding. This bleeding is known as implantation bleeding.

Implantation bleeding means one of the earliest signs of pregnancy, and a woman can confirm her pregnancy through a blood test to check for the Beta HCG hormone. Generally, the signs and symptoms of implantation bleeding are similar to that of a menstrual cycle, so it must not be confused. Rather, the symptoms should be noted so that if there is some serious problem, it could be identified and treated in time. Generally, 1/3rd of women experience implantation bleeding during pregnancy.

Symptoms of Implantation Bleeding

Implantation bleeding time occurs a few days before the next menstruation cycle, which poses a confusion as to whether it is a period coming a few days earlier or it is a pregnancy. However, there are a few additional symptoms to look out for in the case of implantation bleeding. These are:

  • Spotting or bleeding (much similar to menstrual bleeding but may be different in colour)
  • Headaches
  • Nausea
  • Light cramping or pain
  • Pain in the lower back
  • Breast tenderness
  • Mood swings

Implantation Bleeding Vs Periods

Although implantation bleeding or periods may look similar and can happen around the same time, there are a few differences which may help you in identifying one from the other.

  • The difference between implantation bleeding and periods is that menstrual bleeding is red in colour while implantation bleeding may be pink to brown in colour.
  • Implantation bleeding start with mere spotting or discharge as opposed to bleeding in a period which flows heavily.
  • Normal menstrual bleeding lasts for 5-7 days while an implantation bleeding generally lasts for a couple of days only.
  • Commonly, implantation bleeding does not contain clots and is thinner.

When does Implantation Bleeding Occur?

Around 6-12 days after conception or 3-7 days after an embryo transfer, the embryo will attach itself into the uterus lining so that it can derive nutrition from the maternal circulation.

The regular menstruation cycle happens around 11-14 days after ovulation, which is another reason why the two are regularly mistaken for each other. A few women may essentially think their period is a couple of days early. Implantation bleeding duration usually occurs a week prior to the normal menstrual cycle.

Concerns Regarding Implantation Bleeding

Implantation bleeding is a normal phenomenon and is not of much concern. It is usually accompanied by minor cramps and should not last more than a couple of days. However, heavy bleeding or extended bleeding can be a signal of something serious and demands for proper evaluation. Cramping and abdominal pain are normal during the pregnancy, but if it is intense, you should consult a doctor.

The most serious concerns related to implantation bleeding are a molar pregnancy, ectopic pregnancy and miscarriage. If a woman experiences a lot of nausea, light-headedness or fainting along with abdominal pain mostly on one side, then it can be a sign of an ectopic pregnancy.

You should contact a doctor if:

  • There is considerable bleeding after a positive pregnancy test or after a missed period. Such could be an indication of molar pregnancy, ectopic pregnancy or a miscarriage.
  • If there is a suspicion of ectopic pregnancy with pain in the pelvic region, stomach, as well as in the shoulder along with bleeding, it is an emergency situation.
  • If your bleeding is heavier than a period and is joined by fever, chills, and intense cramps.
  • There is substantial blood clotting.

Diagnosis of Implantation Bleeding

As implantation bleeding can be confused with menstrual bleeding, the first test or diagnosis is to confirm the pregnancy. Pregnancy can be confirmed with the help of a home pregnancy test kit. These tests may sometimes give false results. To be perfectly sure, you may take a blood pregnancy test, which is very much accurate.

Sometimes when the bleeding is extended, or you experience a lot of pain, it is best to contact a doctor. Complications may arise in your pregnancy if you ignore the signs of the problems you are facing, such as in case of ectopic pregnancy, molar pregnancy or a miscarriage.

Treatment of Implantation Bleeding

Implantation Bleeding is not a disease. It is a condition that may occur in any woman who is getting pregnant. As told earlier in this blog, implantation bleeding is normal and may last for a day or two. If it extends for more than that, it is time to call a doctor. It clears up itself, so there is no need for a specific treatment.

If in the diagnosis, it comes out that the cause of bleeding is ectopic or molar pregnancy, then treatment becomes necessary. With the help of medication or surgery or both, the condition of ectopic pregnancy and molar pregnancy are treated.

Conclusion

In case you don't know which kind of bleeding you are having, we suggest holding up three days after the spotting stops before taking a pregnancy test. Generally, taking a pregnancy test before the missed period or during implantation bleeding is simply too early for tests to offer a definitive outcome.

Implantation bleeding is an indication of a potential pregnancy. If you have waited until your next period and taken a pregnancy test that had a negative result, then it means you are not pregnant. All women who are pregnant may not experience implantation bleeding.

FAQs

Q1) For how many days is implantation bleeding continues?

A) It varies from a few hours to a couple of days. If it lasts for more than three days, you should consult a doctor.

Q2) Why am I bleeding early?

A) If bleeding occurs much before implantation, there might be some other reason. Consult a doctor to make sure what the problem is. And if you are spotting just before your periods, then it can be implantation bleeding.

Q3) What if I don’t have implantation bleeding?

A) Most women don’t experience implantation bleeding. So it is normal that you don’t experience any implantation bleeding. But make sure to look for other signs of pregnancy.

Q4) I am experiencing some bleeding. Is it implantation bleeding or menstrual bleeding?

A) Look for signs that are particular to implantation bleeding. If your bleeding stops after 2 or 3 days and is not heavy, it is likely to be implantation bleeding.

Q5) Is implantation bleeding painful?

A) No! Although there might be slight bleeding, or cramping, which is normal. However, it is unusual to have intense cramping pain and anyone experiencing it should consult a doctor.

Q6) When is implantation bleeding supposed to happen?

A) Implantation bleeding is usually supposed to occur 10-14 days after conception, or even around the time of your missed periods.

Q7) How long can implantation bleeding last and how heavy can it be?

A) Implantation bleeding last for only one or two days with pretty light bleeding.

References

1) https://www.nejm.org/doi/full/10.1056/NEJMra000763

2) https://academic.oup.com/humrep/article/18/9/1944/708284

3) https://pdfs.semanticscholar.org/0395/e4c19124b090d75694e6bf9e3f2e6f51a180.pdf