Think you’re pregnant but still having your period?

Bleeding in early pregnancy is a common occurrence, but this does not signal a true menstrual cycle. Experts say that women who say they had a period while pregnant either have a different definition of “period”, or honestly think any vaginal bleeding can be termed as “menstruation”

 Everyone seems to know someone who has a friend who had their period during their pregnancy! This seems to happen throughout the generations and is almost an urban legend now. Although many people may have heard of women that had “periods” during pregnancy, the truth is that a woman cannot be pregnant and have a period at the same time. For most women, bleeding during pregnancy isn’t due to a period but some other cause.

 Scientifically, it is not possible to have a ‘proper’ menstrual period while a woman is pregnant. The mechanism for pregnancy and period are different, according to Professor Oladapo Olayemi, consultant obstetrics and gynaecologist, University College Hospital (UCH), Ibadan, Oyo State.

 During a ‘normal’ menstrual cycle, hormonal responses will stimulate the reproductive system to prepare it for a potential pregnancy; maturing and releasing an egg while simultaneously causing the lining of the womb to thicken. If the egg is not fertilised, the lining and egg will be shed as part of the period. 

However, if, on its way down the fallopian tube, the egg is fertilised, the pregnancy hormone hCG (human chorionic gonadotrophin) will override the hormones that control the menstrual cycle, suspending the menstrual cycle and therefore the periods. 

 Since the body will remain in this state throughout the pregnancy, it is impossible to experience a proper menstrual period once conception takes place. Pregnancy and menstruation cannot take place at the same time. It is often vaginal bleeding that women believe is their menses when it is not. 

According to Professor Olayemi, “once there is no ovulation, a woman cannot have what is called a period. What they probably experienced is bleeding in pregnancy. Bleeding in pregnancy could be due to factors such as threatened abortion, implantation bleeding or spotting, ectopic pregnancy, intermittent bleeding, placenta prieva or abortive placenta.” Episodes of bleeding and spotting is especially common in the first trimester and about 30 per cent of pregnant women experience bleeding during this time. 

Early pregnancy bleeding can vary in amounts from slight spotting to vaginal bleeding consistent with a menstrual cycle. Although fewer women bleed during the second and third trimesters, spotting is still possible and not all that uncommon. However, though this bleeding may resemble menstruation, it actually is something different altogether. 

Implantation bleeding or spotting, for instance, is a kind of bleeding that happens when the fertilized eggs, attached to the lining of the womb, cause the lining to shed and, thus, leads to light bleeding for a week or for a few days. Usually brown, pink or light red in colour, it can be mistaken for a light period. If a woman has recently stopped taking contraceptive pills and is pregnant, then such a woman might experience spotting because of the hormonal changes.

 This is more like an intermittent bleeding, rather than an actual period. One of the main symptoms of ectopic pregnancy includes vaginal bleeding. This vaginal bleeding may look similar to a period. Accompanied by shoulder pain, nausea, dizziness and rectal pressure, ectopic pregnancy may give a false impression of a period. 

 Nonetheless, Professor Olayemi stated that “bleeding in pregnancy is not a good thing. Any woman who thinks she is pregnant and bleeding should seek prompt medical help.” Bleeding, which continues to get heavier, accompanied by painful cramping, back pain or stabbing pains, can be the sign of a miscarriage. 

Any unusual bleeding or pains in the lower abdomen should never be ignored as it could be the first signs of having an ectopic or tubal pregnancy. Ectopic pregnancies occur in one out of every 60 pregnancies, and can be life-threatening to both mom and baby. More often, bleeding in the second and third trimesters is caused by an infection in the cervix. Yeast infections and some s*xually transmitted diseases can inflame the cervix causing light spotting or bleeding. 

 So why is it hard for women differentiating vaginal bleeding from a normal period? No doubt, it can be hard for some women to differentiate between the two because it is a common assumption that a missed period is actually the first sign of pregnancy. Where the bleeding that women experience coincides with the same time that they usually see their menstrual cycle each month, they naturally assume that it is their period.

 In addition, if a woman does not keep track of her menstrual cycle, she can easily confuse this bleeding with a menstrual period. According to Professor Olayemi, “such a bleeding will not be regular. For example, a woman could have five days of menstrual period and a 28-day cycle. Once she notices that something is wrong with her period or that it is irregular, she should see her doctor. If she is pregnant, for instance, she would be told she is.”

 When a woman in pregnancy is bleeding, he said, the treatment that would be suggested to stop the bleeding would be determined by the cause of the bleeding and the stage of the pregnancy. “The summary of what we do is to ensure we save the life of the mother. If it is possible, we also ensure we save the life of the unborn child,” he stated.