Vaginal bleeding could be a sign of the menstrual period starting (menstrual bleeding) or it could even be an early sign of pregnancy (implantation bleeding). Both can look very similar, even though they actually happen for very different reasons. In this article, we shall take a look at how to differentiate between implantation vs period bleeding.
Also known as period bleeding or menses, menstrual bleeding is a natural part of the menstrual cycle whereby the uterus sheds its endometrium (inner lining) when a successful conception or pregnancy has not occurred. This results in the discharge of blood and tissue through the vagina. This bleeding may last for three to seven days.
During a normal menstrual cycle, the reproductive organs undergo several processes that prepare them for any potential pregnancy. Hormones will stimulate the growth of eggs within the follicles. At around the same time, the inner lining of the uterus will begin to thicken, enriched with blood and nutrients, to create a nourishing environment for the fertilised egg to be implanted in. During ovulation, hormones will trigger the release of a mature egg from the follicles in the ovaries. This egg will then travel to the fallopian tube, where it will wait to be fertilised by a sperm. If sexual intercourse does not occur during this period, the uterine lining will be shed through the vagina, as there is no fertilised egg to implant.
A typical menstrual cycle usually lasts 28 days. The first day of menstrual bleeding is considered day 1 of the menstrual cycle, typically occurring around 14 days after ovulation. Once the bleeding stops, the cycle will restart, and the uterine lining will begin to thicken again.
Implantation bleeding refers to the light bleeding (also known as spotting) that sometimes occurs when the fertilised egg gets implanted or embedded into the lining of the uterus. It is one of the earliest processes that marks the start of a pregnancy. This type of bleeding is normal and usually lasts for only a couple of days.
If sexual intercourse has occurred during the ovulation phase and the egg has become fertilised by a sperm, it will travel to the uterus and attach itself to the inner lining. During the days preceding ovulation, increased levels of estrogen and progesterone would have stimulated the uterine lining to become thick and filled with blood vessels, thereby creating a nourishing environment for the egg. When the fertilised egg embeds itself into this nutrient-rich uterine lining, it may disturb tiny blood vessels, leading to light bleeding known as implantation bleeding.
Implantation bleeding happens in the very early stages of pregnancy, often around 10 to 14 days after ovulation. In fact, in some cases, this is considered to be one of the first signs of pregnancy.
Here are the main factors that can help differentiate between menstrual bleeding and implantation bleeding:
Menstrual bleeding usually lasts from three to five days (or longer). Implantation bleeding typically lasts only a few hours or a couple of days, never longer than that.
Menstrual bleeding is much heavier than implantation bleeding. Only light spotting is noticed during implantation bleeding, whereas, for menstrual bleeding, there’s usually a stronger blood flow. Therefore, sanitary napkins, tampons, and other similar products will only be required during menstrual bleeding. Also, women may notice the presence of period blood clots while they are menstruating. This will be absent in implantation bleeding.
The light spotting that occurs after implantation is usually light pink or brown. Menstrual blood, on the other hand, will usually be bright red to dark brown in colour, and the colour may change during the menstrual period.
Women may experience a range of symptoms during their menses. They may have severe abdominal cramps, bloating, breast pain or tenderness, etc. Women with implantation bleeding may only have mild cramps. However, they may have slight nausea, which is actually one of the other early pregnancy signs to look out for if pregnancy is suspected.
To be sure about the cause behind the bleeding, it is best to take a pregnancy test. This is especially recommended for women with irregular menstrual cycles or those who have had unprotected sexual intercourse during ovulation or are unable to positively differentiate between the two types of bleeding.
In the case of menstrual bleeding, if the blood flow is lighter or heavier than usual or if the bleeding lasts for an abnormally long time, then medical advice should be sought to rule out any underlying conditions.
In the case of implantation bleeding, it may be best to consult a gynaecologist if the blood flow appears heavy or if it lasts more than 2 days, especially if the pregnancy test has confirmed successful conception.
It can be quite difficult at times to differentiate between implantation bleeding and menstrual bleeding. For women trying to get pregnant, this can feel like an overwhelming and frustrating task. However, by using the information in this article, it will become easier to spot the subtle differences between these two.
