Do you get implantation bleeding before your period

During pregnancy, your body goes through all kinds of changes. Some are obvious and expected, like a growing belly or the stoppage of your menstrual cycle. But did you know that very early on, you may experience some bleeding that could be mistaken for your period? This is called implantation bleeding, and we sat down with Heather Reed, MD, an obstetrics and gynecology physician and medical director of labor and delivery at Banner – University Medical Center Tucson, to learn what it is and when you should be concerned.

Q: What is implantation bleeding? Is it normal?

A: Pregnancy starts when an egg is fertilized in the fallopian tube and then makes its way to the uterus. When the fertilized egg reaches the uterus, it attaches to the uterine wall. When this attachment happens, you may experience a small amount of bleeding. This is called implantation bleeding and it is completely normal.

Q: How much bleeding is normal?

A: The amount of bleeding at implantation can vary between women. Some women may not experience any bleeding with implantation, while other women may have bleeding that compares to a light period and lasts two or three days. Anything on that continuum – from no bleeding to bleeding resembling a light period – can be considered normal.

Q: I’m experiencing bleeding that is heavier than a light period. Should I be worried?

A: Because implantation can be the same time as you might be expecting your period, it can be hard to tell the difference between implantation bleeding and your regular menstrual bleeding. It’s tough to know when you should be worried because every woman’s circumstance is different. However, any time bleeding saturates a pad in less than two hours it should be considered too much vaginal bleeding, and you should consult a physician.

Q: Are there other symptoms associated with implantation bleeding?

A: Some women experience slight cramping or nausea during implantation, in addition to light bleeding. Because implantation occurs so early in pregnancy it can be difficult to tell if the symptoms are from implantation or your regular monthly menstrual cycle.

Q: How do I know the difference between implantation bleeding, my menstrual period, and a miscarriage?

A: Unfortunately, there’s no way to tell the difference between implantation bleeding and menstrual bleeding. Implantation occurs 6-12 days after conception, which is around the same time you may be expecting your monthly period, and both can produce the same amount of bleeding.

If you think you may be pregnant, your best bet is to take a home pregnancy test. The level of human chorionic gonadotropin (hCG), a pregnancy hormone, can vary between women but most home pregnancy tests can detect pregnancy. However, it’s important to know that a home pregnancy test can produce a false negative because everyone’s hormone level is slightly different. While it’s possible to become pregnant and lose the pregnancy this early on – resulting in light bleeding that could be confused with implantation bleeding – a pregnancy loss this early isn’t considered a miscarriage.

If you think you’re pregnant, it’s best to make an appointment with an OBGYN. An OBGYN can provide a pregnancy blood test and if you are pregnant, start important prenatal care right away.

For additional information, check out these related articles: Is My Period Normal? — 7 Signs You Might Be Pregnant — Things You Should Know About Well-Women Visits. And for other helpful advice regarding pregnancy, visit the Banner Health blog. 

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Implantation bleeding can occur about 10-14 days after conception when the fertilized egg attaches to the interior lining of the uterus. This movement of the egg can result in light bleeding or spotting, which is completely normal and should not require any kind of medical attention. Generally, around a third of pregnant women will experience implantation bleeding. While similar in timing to a woman’s menstrual period, the two are different. Implantation bleeding is lighter than menstrual bleeding.

Implantation Bleeding Symptoms

Implantation bleeding is considered one of the early pregnancy symptoms (at least one of the first easily identifiable signs for a mother). Because implantation bleeding occurs near the time of her next period, many women are confused whether it is a possible pregnancy or a period. Here are other signs of implantation bleeding

• Light or faint cramping (less than a normal period cramp)
• Mood swings
• Headaches
• Nausea
• Breast tenderness
• Lower backaches

(These can also be PMS symptoms or ovulation symptoms, so having these along with pinkish/brownish spotting does not guarantee that it has to do with pregnancy.)

What Does Implantation Bleeding Look Like?

Implantation bleeding looks a bit different from the average woman’s period. It is important to remember that not all women have the same kind of blood flow during their menstrual period. Some will have a heavier flow during their period while others may experience a bit more unpredictability.

These are the key differences between implantation bleeding and a period:

1. Color.  Whether heavy or light, most women are familiar with the color of their period (usually a bright to dark red). Implantation bleeding, however, is typically light pink to dark brown (rust-colored) in color.
2. Clotting.  Some women experience a great deal of clotting during their menstruation, while some do not see much at all. Implantation bleeding, however, should not present any clots.
3. Amount.  Most women are able to fill pads and tampons during their periods, but with implantation bleeding, it is different. The descriptor “bleeding” can be misleading – implantation bleeding is usually only spotting or a light flow rather than a full flow. Typically, implantation bleeding is a little pink or brown discharge only when a woman wipes or just enough to get on a pantyliner. It may be either intermittent or a more constant light flow.

How Long Does Implantation Bleeding Last?

Implantation bleeding should last only between a couple of hours to three full days. If the bleeding you are experiencing is bright or dark red blood, lasts more than three days, and is a full flow in that you are filling up pads/tampons, it it very unlikely you are experiencing implantation bleeding.

Women who are going through their first pregnancy will likely spot or bleed a little bit more than women who are used to the egg attachment. (It is similar to dental flossing of the gums as the first time the gum line is aggravated, it will bleed more, while subsequent times bleeding is lessened.)

However, if your menstruation cycle is shorter than normal (< 3 days), you did not fill up pads or tampons, it was more pinkish/brownish than red, and you had less cramping than normal, it is possible that you are having implantation bleeding.

Why Does Implantation Bleeding Happen?

About 10-14 days after conception (when the sperm joins with the egg), the embryo will implant itself into the wall of the uterus. This movement may break down some blood vessels within the uterus wall and cause some bleeding.

Menstruation occurs around 11-14 days after ovulation (when an egg is released & conception is possible), which is another reason why the two are often confused with one another. Some women may simply believe their period is a few days early. Implantation bleeding typically happens within the week before the expected period.

For example, if you are sexually active and expect your period on January 25th, then you might question any spotting you have between Jan. 18th – Jan. 25th as possible implantation bleeding. It is not common that implantation bleeding would occur before this time or after a period is expected or missed. However, if one experiences ovulation early in the fertility window and the implantation process is quick, or one experiences ovulation late in the fertility window and the implantation process is slow, it is possible.

Women know what their normal menstrual flow looks like, and as long as they are not on any kind of new medication (including birth control and emergency contraceptives) or have a change in stress level, then their menstrual blood flow, color, and consistency are usually the same. So, when this lighter, pink spotting occurs, it will appear a bit out of place.

Implantation Bleeding Concerns

Implantation bleeding should not be a cause for concern and should pose no real risk to the developing baby. If you experience bleeding or spotting more than a few days after your missed period, it is not likely to be implantation bleeding. True pregnancy concerns rarely come from implantation and usually occur after the missed period.

Though this post-implantation light bleeding during pregnancy is not considered normal, there are a few main reasons it may occur:

• Irritation of the cervix (especially following OBGYN exams)
• Irritation or small tears from intercourse
• Heavy or excessive lifting or exercise/exertion
• Vaginal infection.

At least 50% of women that experience spotting/bleeding (other than implantation bleeding) will go on to have a normal, healthy pregnancy.
Extended bleeding can be a sign of something more serious, especially further on during the pregnancy. Molar pregnancy or miscarriage are two concerns, which is why whenever visiting the OBGYN or other doctors, it is necessary to inform them of current or recent bleeding (especially if it is heavy), as well as any other symptoms you are experiencing.

In your first trimester, be sure to let your healthcare provider know about any spotting.
Let your healthcare provider know immediately about any spotting in your second or third trimesters.
If at any point during your pregnancy you experience heavy bleeding, contact your healthcare provider immediately or consider seeking emergency care.

For women going through nausea/vomiting, dizziness, abdominal pain (especially one-sided pain), it is possible you are experiencing an ectopic pregnancy, so inform your doctor right away. Cramping is normal during pregnancy, yet if the level of pain during cramping increases, it is recommended to contact a doctor.

Still Not Sure?

If you are not sure which type of bleeding you are having, we recommend waiting three days after the bleeding/spotting stops before taking a pregnancy test. You are welcome to contact our toll-free helpline at 1-800-672-2296 to speak with a pregnancy educator.

Often, taking a pregnancy test before the missed period or during implantation bleeding is just too soon for tests to offer conclusive results. Ideally, waiting a week after the spotting or missed period is most desirable as the results should prove more accurate.

Next Steps

Implantation bleeding is a sign of a potential pregnancy. If you have waited until after your period was due and taken a pregnancy test that delivered a negative result, there is a good chance you are not pregnant. Watching for implantation bleeding while trying to get pregnant is fine, but many women do not experience nor notice implantation spotting even when it does occur.

Want to Know More?

• Early Symptoms of Pregnancy
• Getting Pregnant After Ovulation
• Bleeding During Pregnancy

Compiled using information from the following Medical sources:

1. March of Dimes: “Pregnancy Complications.”

2. National Institute of Child Health and Human Development: “What Are Some Common Signs of Pregnancy?”

3. American College of Obstetricians and Gynecologists: “Abnormal Uterine Bleeding,” “Early Pregnancy Loss.”

4. Norwitz ER, et al. Overview of the etiology and evaluation of vaginal bleeding in pregnant women.

5. Moore KL, et al. Answers to clinically oriented questions. In: Before We Are Born: Essentials of Embryology and Birth Defects. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2013.

6. Frequently asked questions. Pregnancy FAQ038. Bleeding during pregnancy. American College of Obstetricians and Gynecologists.

https://www.acog.org/Patients/FAQs/Bleeding-During-Pregnancy

7. American College of Obstetricians and Gynecologists. Months 1 and 2. In: Your Pregnancy and Childbirth Month to Month. 6th ed. Washington, D.C.: American College of Obstetricians and Gynecologists; 2015.

8. Mayo Clinic FAQs

How many days before expected period do you get implantation bleeding?

How can I tell if it's implantation bleeding?

Can you have implantation bleeding a week before your period?