Any pregnancy that ends in a miscarriage (spontaneous abortion) or is terminated out of choice (induced abortion), will still result in a number of hormonal changes in a woman’s body. Even weeks after the abortion, the residual effects of having been pregnant earlier will still be noticeable.
Of these changes, many women are concerned as to when the menstrual cycle will return to a normal state. The periods may be irregular, heavy or light, or may not have started as yet (amenorrhea). Clots, period pain and PMS are other common symptoms reported by women. The changes in periods after pregnancy is usually temporary and should restore to the pre-pregnancy state within 6 weeks if not sooner.
Periods after Spontaneous or Induced Abortion
Human chorionic gonadotropin (hCG) is a hormone produced during pregnancy which suppresses the pituitary gland. This prevents the gland from producing the hormones luteinizing hormone (LH) and follicle-stimulating hormone (FSH) which cause ovulation.
Depending on the type of abortion and stage of pregnancy when terminated, a dilation and curretage (D&C) may be necessary. After the D&C is done, the hCG level drops. For the menstrual cycle to start, hCG level must drop to zero, which usually takes about 2 weeks, but will actually depend upon the hCG value before the abortion.
- In normal circumstances, the periods should start within 4 to 6 weeks after a first trimester abortion or miscarriage. In case of very early miscarriage, the periods may start even earlier.
- In women with irregular periods prior to pregnancy, the first period after abortion may come as late as 12 weeks.
- If a D&C was done after the miscarriage, periods can be expected to start after 4 weeks.
- In case of an abortion where a D&C was not done, it may take about 6 weeks for the menstrual period to commence.
- After stillbirth or late stage pregnancy loss, it may take 2 to 3 months for the periods to start.
- It may also take a few cycles for the regular periods to be re-established.
- It is possible to get pregnant even 2 weeks after an abortion since ovulation may occur around this time even without a menstrual period. Therefore contraception should be considered immediately after a miscarriage or induced abortion.
- Asherman’s syndrome is a condition that can develop as a result of a vigorous curetting during a D&C procedure or following repeated D&C’s done in multiple abortions. Bands of scar tissue or adhesions form inside the uterus. This may cause a woman to suffer from scanty periods or even amenorrhea (cessation of periods) following abortion.
A spontaneous abortion (miscarriage) or induced abortion affects different women in different ways. Some women need time to come to terms with the loss and may suffer with anxiety or depression following the incident. The altered mental state may affect the periods despite the physiological post-abortion effects having subsided.