Does ectopic pregnancy cause heavy bleeding, spotting, and abdominal pain?

Q. I have heavy bleeding and spotting at times. Is there a possibility that I might have ectopic pregnancy?

Answered by
Dr. Sameer Kumar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Feb 25, 2015 and last reviewed on: Dec 22, 2018

Hello doctor,

I am 21 years old. I decided to contact you because I do not know what to do. I had sex with my husband, and then we found out that he had a chlamydia infection. Since then, I am feeling sick all the time. My stomach was hurting a lot, and I had problems with passing urine, and it started to hurt deep inside. I went to a sexual health clinic, and I had a test (it came out as negative after one week), and they treated me for chlamydia. I was told to wait for a week for the symptoms to stop, but it was just getting worse and worse. I had heavy bleeding, spotting at times, and I was not able to move because of the pain. Those are just some of the symptoms I was having.

I came back to the clinic, and they thought it could be PID (Pelvic Inflammatory Disease). So, they treated me for that. But those antibiotics did not help as well. I still have abdominal pain. I can feel something moving and kicking inside me. It is there all the time. I was at the clinic yesterday, and I had two pregnancy tests. The results came out the same (one clear line and the other one very light). The possibility of me being pregnant is very less because I was taking birth control pills for 2 years, and we always use condoms. Except for one time which was two months ago, but my husband did not ejaculate inside me.

I did not have periods for 2 years, and that is why the bleeding worried me. I stopped taking birth control pills one week ago because I was worried that it could be pregnancy. I have read a lot about ectopic pregnancy, and the symptoms are the same as what I have been experiencing. I did two pregnancy tests at home, and they were negative. The sexual health clinic said that there is a possibility that I might have an ectopic pregnancy. I am very scared. It has been two months already, and I cannot stand it. What do I do? Am I pregnant?



Welcome to

If pregnancy is the concern, then the best way to find out is to get a blood serum beta hCG test done. This is a confirmatory test for pregnancy as the urine pregnancy kits may show false positive results. If the level of hCG is more than 1 or raised, then pregnancy is confirmed. If the level is less than 1, then pregnancy is completely ruled out.

If the test is positive, then you should undergo an ultrasound pelvis to locate the pregnancy for its site, which could be intrauterine or possibly in the tubes (ectopic). If the USG shows extrauterine pregnancy, then you would require a laparoscopic salpingectomy to remove the damaged tube along with the ectopic pregnancy. If the pregnancy is intrauterine, then you may decide upon continuing the pregnancy.

If the test is negative, then the possible cause remains UTI (Urinary Tract Infection) or a possible PID (Pelvic Inflammatory Disease) or endometriosis. Also, stress per se can cause derangement of hormonal balance and can cause heavy bleeding in spite of being on continuous progesterone pills. This can be controlled with antifibrinolytics in the absence of pregnancy.

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