Can you be pregnant and still get your period?

Q: Can you be pregnant and still get your period?

A: The answer to that question is no- a true period is the result of shedding of the endometrium, or lining of the uterus, which occurs as a result of ovulation ( midcycle release of the egg) and the cyclic changes in estrogen and progesterone.  Women do not ovulate when they are pregnant, and although bleeding in pregnancy is common, it is never normal.  If a woman is pregnant and bleeding, with  or without pain, she should call her doctor for further instruction.  Bleeding in the first trimester of pregnancy may signify either a miscarriage (or a threatened miscarriage), an ectopic pregnancy, or may be due to implantation bleeding.  If one is experiencing a miscarriage (or a threatened miscarriage) one will usually always have bleeding associated with uterine cramping.  There may also be passage of large clots from the vagina.  If this is happening one should definitely seek care at the doctors office or the local ER if after hours.


Another cause of bleeding is an ectopic pregnancy (or tubal pregnancy). The amount of bleeding with an ectopic may vary in amount and is usually associated with unilateral pain (pain primarily located on the left or right side) plus or minus dizziness or lighheadedness.  Ectopic pregnancy can be life threatening if it ruptures so the more rapid the diagnosis the better for the patient.  If a patient is having any of the above symptoms such as bleeding and pain, especially localized pain, she should call her doctor or get to the ER immediately. Implantation bleeding is usually fairly light but develops as the embryo is implanting into the uterine lining. 


Often times, the cause of the bleeding may not be known, which is very alarming for the patients and very anxiety provoking.  Usually patients will be told to go home and be on bedrest and pelvic rest until the bleeding stops and will be followed closely with obstetric ultrasounds and possibly blood tests to check the HCG levels if that is clinically indicated. 


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