What causes prolonged bleeding after an abortion?

Question

Hello doctor,

I am a 23-year-old female. I had an abortion in the fourth month of pregnancy. After the abortion, there were three months of continued bleeding. I am taking Transamine 500mg three times, CaC-1000 two times, and a Sangobion capsule once daily. There is no infection and pieces of pregnancy left in ultrasound. The ultrasound had been clear, but the bleeding did not stop. Please tell me what could be causing this and how to treat it. Kindly give your suggestions.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I am sorry you are going through this. Three months of continuous bleeding after an abortion is not normal, especially if your ultrasound shows no retained tissue or infection. Here are some possible reasons and next steps for treatment:

Prolonged bleeding can be due to:

Hormonal imbalance as your body may still be adjusting after pregnancy and abortion, leading to prolonged uterine bleeding.
Endometrial issues, wherein your uterine lining (endometrium) might be too thin or too thick, causing irregular bleeding.
Some women develop coagulation issues after pregnancy, making it harder for the bleeding to stop.
If your uterus is weak and is not contracting properly, it might not fully heal, leading to ongoing bleeding.
Side effects of hormonal contraception. If you have started using birth control, it might be affecting your cycle.

I suggest you do the following:

Since you have been bleeding for months, you could be anemic. Check your hemoglobin and iron levels by getting a blood test like CBC (complete blood count).
Some women need progesterone or combined oral contraceptives to regulate bleeding.
Another ultrasound (preferably a doppler ultrasound) is needed to check for blood flow issues or small abnormalities in the uterus.
Consult a gynecologist again. Since it has been three months, your doctor may consider other treatment options like dilation and curettage or hysteroscopy to check for issues inside the uterus.

Visit a doctor immediately:

If you feel dizzy, weak, or faint (signs of severe anemia).
If bleeding suddenly worsens (soaking pads within an hour).
If you develop severe cramps, fever, or unusual discharge (signs of an undetected infection).

Since you have already ruled out retained tissue and infection, your hormonal balance and uterine healing process need to be checked further. Please consider seeing a gynecologist as soon as possible to find the best treatment. I hope this helps you.

Thank you.