This section covers several issues related to menstruation that aren’t covered in the normal periods or abnormal pain and bleeding sections.

How will a miscarriage affect my menstruation?

During the miscarriage

When a pregnancy ends on its own prior to 20 weeks of gestation, it is called a miscarriage. An early miscarriage (in the first 6-7) weeks will usually be just like a regular period. Miscarriages that happen beyond then cause bleeding that is heavier than a regular period, and you may experience more cramping. You will likely be able to see some tissue and large clots passing as well. This process often completes on its own, but can sometimes require medical intervention. Medication or dilatation and curettage may be used to clear out any tissue remaining in the uterus. You may have bleeding for a week or two after the miscarriage.

After the miscarriage

Usually you will get your next period somewhere between 3 and 6 weeks after your miscarriage. If you have a lot of spotting and recurrent bleeding, you may have some tissue retained in your uterus – see your doctor to determine if you need further treatment. It may take a few cycles for your period to become regular again. If you had a late miscarriage (between 12 and 20 weeks gestation), it may take a little longer. If your periods stay very irregular, you may not be ovulating.

How will an abortion affect my menstruation?

After an abortion, you can expect to have vaginal bleeding that lasts from 2-6 weeks. You will likely get your next period within 4-8 weeks of the abortion. In many cases you will be started on hormonal birth control immediately after the abortion. This is perfectly safe and may help reduce bleeding. If not, it is important to remember that you will likely ovulate before your next period arrives, so be sure to use a form of birth control during this timeframe. Depending on what type of abortion you had, your first period or two may be different than normal – either lighter or heavier. However if you are passing large clots or bleeding heavily, you should see your doctor as you may have some tissue retained in your uterus.

Can I safely suppress my period using birth control?

There are a number of circumstances under which you might choose to suppress your menstrual period.

It is possible to adjust the timing of your periods by using hormonal birth control methods. These include oral contraceptives, the vaginal ring, skin patch, implant, depot injection, or IUD. Using a continuous dose of hormones can be used to suppress menstruation to prevent PMS-related symptoms, for convenience (e.g., preventing a period from happening while you are on vacation), or to help treat iron-deficiency due to heavy menstrual bleeding.

Continuous dosing is safe and can be very effective in controlling heavy menstrual bleeding. There are no known additional risks associated with menstrual suppression beyond those that exist for the regular use of oral contraceptives; in fact, prior to the advent of modern methods of birth control, women had far fewer periods since they had menstrual suppression from pregnancy or breast feeding for many years of their lives. In the first few months of continuous dosing of hormones, you may experience spotting and irregular bleeding. Usually this subsides after about 3 months.

Is hormonal birth control safe?

Birth control pills or hormonal IUDs are safe for the majority of women. In fact, women who have been on hormonal methods for menstrual suppression or birth control have less anemia, less time off work, less acne, and may have less PMS. Women who used these methods over several years have a lower chance of endometrial or ovarian cancer.