Bleeding in pregnancy: Pregnancy can be confusing, especially when your body seems to break its own rules. A common question is whether you can be pregnant and still get your period. At first glance, the answer sounds like “no,” since a missed period is often the first sign of pregnancy.
Why do women bleed every month?
Each month, the uterus builds a nutrient-rich lining to support a possible pregnancy. If conception doesn’t happen, that lining is shed as a period. If you are pregnant, the body keeps that lining to nourish the embryo, so a true menstrual period does not occur once pregnancy begins.
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Why do some pregnant women still bleed?
Some of the reasons include:
- Implantation bleeding: In very early pregnancy, a small amount of bleeding can occur when the fertilised egg attaches to the uterine wall. It often shows up around the time a period is due, appears as light pink or brown spotting, and is easy to mistake for a very light period.
- Hormonal shifts: Early in pregnancy, hormones may not stabilise right away. Around the expected period date, a tiny portion of the uterine lining can shed, causing light-to-moderate bleeding with mild cramps. This isn’t a true menstrual cycle and doesn’t mean you’re not pregnant.
- Cervical irritation: Increased blood flow makes the cervix more sensitive during pregnancy. Sex, a Pap test, or strenuous activity can irritate it and lead to brief spotting. This is usually harmless for the baby but can be confusing if you’re not expecting it.
- Miscarriage: Bleeding with cramping in the first trimester can signal a possible miscarriage. Some pregnancies continue normally; urgent evaluation helps clarify what’s happening.
- Ectopic pregnancy: When the embryo implants outside the uterus (often in a tube), bleeding may occur with one-sided pain, dizziness, or shoulder pain. This is an emergency. Seek immediate care.
- Infections: Cervicitis, STIs, or urinary/vaginal infections can inflame tissues and trigger spotting. Testing and treatment are important to protect you and the pregnancy.
- Fibroids: Uterine fibroids may bleed or ache as they change during pregnancy. Most are manageable with observation.
- Procedures and medications: Recent Pap tests, transvaginal ultrasounds, progesterone suppositories, blood thinners, or bleeding disorders can contribute to spotting.
- Haemorrhoids or anal fissures: Bright-red blood on toilet paper may come from the rectum, not the vagina, due to constipation and straining.
When to call a doctor?
Call your doctor right away if you notice:
- Heavy bleeding (soaking a pad)
- Bright red blood with clots
- Strong cramps or pain in your belly
- Dizziness or fainting
- Pain in your shoulder
Can you be pregnant and still have your period?
No, once pregnancy begins, a true menstrual cycle stops. What some people notice is bleeding that resembles a period, but biologically, it isn’t menstruation.
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You can have light bleeding or spotting in early pregnancy from causes like implantation, hormonal shifts, or cervical irritation. If you’re unsure about any bleeding, contact your clinician.