Q. I did not bleed after taking Misoprostol. Why?

Answered by
Dr. R Balakrishnan Menon
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 25, 2017 and last reviewed on: Oct 09, 2018

Hi doctor,

I started bleeding heavily after taking Mifepristone. It was not regular periods but thick blood clots, which lasted for a day. On the next day, I inserted a Misoprostol in the vagina, as I will be taking one tablet after every 12 hours (in total four tablets). After the first tablet, I got cramps but no bleeding. Now, I am waiting to put one more tablet after 12 hours, but I am worried since I did not bleed after the first tablet.

#

Hi,

Welcome to icliniq.com.

How are you doing?

Mifepristone is a hormonal pill which will dislodge the embryo from the uterus, that is the embryo will be will be free from the walls of the uterus after 48 hours.

Having four tablets of Misoprostol 200 mcg orally or vaginally at a time is simpler, easier, and can avoid all the confusion of having it at repeated intervals. But remember, if you are using vaginally, just wet it before keeping the tablets, or else they will not dissolve and will have no effect.

  • This pill will make the cervix softer and will make the uterus contract pushing the products out of the uterus. So, the bleeding you saw was due to the initial separation and the cramps were due to the uterus attempting to throw the product out.
  • I would suggest you try keeping all the remaining tablets together at a time vaginally. Do not worry this has no problem, this will reduce the chances of failure too. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent.
  • If the pain is unbearable, have any of the antispasmodics like tablet Cyclopam (combination of Paracetamol and Dicyclomine) or Hyocimax (Hyoscine), 2 to 4 times a day, depending on the severity of the pain. After two weeks of bleeding, have a scan to confirm the products is fully gone.

Hope I have clarified your query, do write back.

For further queries consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hello doctor,

Thank you for replying. The pills did not work for me so had to go through a surgical abortion. But during an ultrasound, I found out I have a cyst, even though I have been given medication. I wanted to confirm from you, how severe it is? Kindly find the attachment of my ultrasound report.

#

Hi,

Welcome back to icliniq.com.

How are you doing? It is sad to know that a surgical intervention was needed. I have seen your report (attachment removed to protect patient identity).

  • The cyst is nothing but the corpus luteum hematoma. The ovarian cyst which would have supported the pregnancy, had it been there. The previous pregnancy scan did not show the cyst?
  • Just forget about the cyst, repeat the scan after 1 to 2 months, it would have disappeared or shrunk. No need to do anything now. Just relax, you will do fine.

For more information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hello doctor,

Thank you for the reply. Since today morning 5 AM, I started having pain deep inside my vaginal wall on the right side and between the vagina and the anus. I cannot tell exactly where the pain is. I feel the vagina and anus are swollen. Sitting on the toilet seat, standing, and sitting in hot water helps a bit.

#

Hi,

Welcome back to icliniq.com.

How are you doing? Sad to know that you are in pain since morning.

  • This is the complication we would want to avoid when we finish the abortions with oral and vaginal medicines. After 5 to 7 days of any procedures like D and C, there can be mild infection and edema to the surrounding structures, usually, the muscles and ligaments that hold the uterus. When there is edema or swelling of these structures, they give a feeling of swelling and pain of that area. That seems to be the symptoms you are suggesting.
  • But do not worry, this can be cleared with some oral medications. I suggest you try taking the following.
  1. Tablet Ciplox TZ (Ciprofloxacin and Tinidazole) or Doxycycline 100 mg or Hicef 200 (Cefixime) or Bicef (Cefadroxil) or Pulmocef 200 (Cefuroxime) or Cefpod 200 (Cefpodoxime) or Kefpod-CV (Cefpodoxime and Clavulanic acid), twice a day for seven days.
  2. Painkiller and to reduce edema, tablet Chymoral forte (Trypsin and Chymotrypsin) or Seratid -D (Serratiopeptidase), twice a day for five days.
  3. Usually, you will have gastritis, for that, tablet Pan 40 (Pantoprazole), on an empty stomach twice a day for three days.
  • You will be absolutely fine within 3 to 4 days. But, do complete the course. At least in future, try to always ask for an alternative medical method for any procedure. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent.

Hope I have clarified your query, do write back.

For further queries consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

I am so grateful to you doctor. Thank you very much. I really appreciate all your help.

#

Hi,

Welcome back to icliniq.com.

  • It is so nice to be of help to you. Wish I could do better if I was there. Hope the problem is solved within the expected time. Do let me know of the progress and you will surely be better next week. All the best.

For more information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

Hope all is well with you. As you know about my abortion history, unfortunately, I broke up with my boyfriend and now married to another man. I am worried that when I get pregnant, I will not be able to tell my doctor about my abortion history. Because my husband will be with me and the doctor knows my husband and his family well. Also, I am not sure how safe it is to tell my doctor. Is it possible for a doctor to know if I hide? I am worried. Please help.

#

Hi,

Welcome back to icliniq.com.

It is so lovely to hear from you. I am doing fine. Happy to hear that you are up to a fresh start in life.

Again, I will advise you just to relax and forget the past. The doctor or your partner cannot diagnose if you were ever pregnant or had an abortion. Even scans cannot diagnose it. The only way they can know is if you say it. Even these emails need to be deleted.

The doctor is not going to examine you anyway as you can decide that and no blood or body investigation can diagnose history of pregnancy or abortion. The use of those medication and D and C are not going to affect your pregnancy chances. So just relax and erase all the bad memories. All the best for a happy, prosperous and brighter future.

For further information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Thank you doctor,

It is a huge relief. I have attached my preconception test reports which I had done myself with a different gynecologist, and she said reports are normal. My pap smear report says "cellular changes associated with inflammation and repair." When I asked she said it is due to infection, and I was given medicine, but I was worried that it might be due to abortion. After hearing from you, I am sure abortion is not the cause. Since doctor said all reports normal, I have told my husband about the tests and when I conceive I would like to go to our family gynecologist with these reports. Kindly go through my reports so that I will be 100% confirmed. Also, I had never done HIV test before, and I do not know about my ex-partner status. But this time I had to go through this test and the result is not reactive as you can see in the report. This test was done after 9 months of physical contact with my ex. Is the report 100 % conclusive? Many thanks in advance.

#

Hi,

Welcome back to icliniq.com.

Yes, all your reports are normal (attachment removed to protect patient identity). Do not worry about the PAP smear report, it just means there is some mild inflammation. Any lady who had a sexual exposure will have some inflammation in the cervix.

As you mentioned, HIV has a window period of three months. If you had been positive, it would have seen in the test performed after nine months. So you are definitely HIV free.

I did go through all the extensive reports, they are all perfectly normal. You do not need any medication at all. You can show it to your doctor and they cannot find any fault. So just relax and forget about the past.

For further doubts consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist


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