Last reviewed by Dr. Raj MD on January 12th, 2022.
Implantation bleeding is one of the common signs of pregnancy. Many women oftentimes have mistaken it for a menstrual period. However, if you are sexually active and/or trying to get pregnant, you need to be extra cautious with implantation bleeding.
Research showed that about 25% of pregnant women experience implantation bleeding or some degree of bleeding during pregnancy. In this article, we are going to discuss implantation bleeding, what does it look like, when it occurs, and what can you do about it. (1, 2, 3)
Photo 1: Sanitary pads demonstrating implantation bleeding at a varying degree.
Picture Source: 1.bp.blogspot.com
What is implantation?
Implantation takes place when the fertilized egg attaches/implants itself to the lining of the uterus. It usually takes place six to 12 days after fertilization. During ovulation, the ovary releases an egg. If there is a sexual contact, the sperm will fertilize the egg and form a zygote. The zygote will travel to the fallopian tube until it reaches the uterus and implants itself in the lining. (2, 3)
Stages of Implantation
- Stage 1 (Adplantation) – The embyo is approximately six days old and attach itself to the uterine wall.
- Stage 2 (Adhesion) – The egg deeply penetrates to the uterine wall.
- Stage 3 (embedding) – The embryo embeds deep in the uterine wall. (3, 4, 5)
What is Implantation bleeding?
Implantation bleeding is a small amount of bleeding, so-called spotting during pregnancy. It usually occurs in the first few days of pregnancy. In fact, it comes shortly before the time you expect your menstrual period. Hence, many women think that they are having a menstrual period, when in fact, it is a sign of pregnancy.
The hormone progesterone is the one responsible for thickening the uterine wall. If there is no sexual contact, the thickened uterine wall will shed off blood, which we call menstruation. If there is sexual contact and fertilization takes place, the zygote will embed itself in the uterine lining causing slight bleeding, which we call implantation bleeding. (5, 6, 7)
Image 2: A comparison image between an implantation bleeding and a regular menstruation.
Picture Source: i1.wp.com/conceivesuccess.com
When does implantation bleeding occur?
Implantation begins a few days before the next menstruation cycle. It is the primary reason why many women confused implantation bleeding with menstruation. To differentiate implantation bleeding from menstruation, you should look out for additional signs:
- Mild abdominal cramping
- Nausea (9)
- Mood swings
- Lower back pain
- Breast tenderness
- Frequent urination
- Fatigue (8)
What does implantation bleeding look like?
Photo 3: Recognizing implantation bleeding.
Picture Source: www.wikihow.com
An implantation bleeding looks different than the menstrual bleeding. To help you easily distinguish implantation bleeding from that of menstrual bleeding, you need to carefully observe the following:
Implantation bleeding vs period
#1 Implantation bleeding color
- Menstruation – bright to dark red
- Implantation bleeding – light pink to dark brown, more like rusty red
#2 Presence of blood clot
- Menstruation – blood clot is usually present during menstruation period.
- Implantation bleeding – Blood clot is not possible in implantation bleeding.
- Menstruation – A woman’s regular period ranges from 3 to 7 days. However, there are factors that can affect the duration of bleeding such as use of birth control. Those who do not practice birth control have longer bleeding duration than those with birth control.
- Implantation bleeding – It could last for a few hours to 3 days. (9, 10, 11)
#4 Amount of blood
- Menstruation – The entire pad can be filled with blood, especially during heavy days. The blood flows continuously.
- Implantation bleeding – The amount of blood is similar to that of spotting. In fact, many women don’t notice that they have implantation bleeding until they wipe their private part and they noticed light pink to brownish discharge. The blood flow is on and off. (11, 12)
Cardinal Signs of Implantation Bleeding
Image 4: Blood colors that differentiate implantation bleeding from regular menstrual bleeding.
Picture Source: www.invitra.com
|Blood flow||The blood flow is very light, more like spotting. Heavy flow rarely happens and does not always indicate an abnormality, especially if it lasts for a few hours.|
|Color||The color of the blood is usually brown or pink. In some cases, the color of the blood is light red. If the color is a bit brownish/rusty, do not panic. It could be an old blood stuck in the uterus. (14)|
|Cramping||Abdominal cramping is possible with implantation bleeding. The cramping is secondary to contraction of the uterine muscles as the zygote burrows itself into the uterine lining.|
|Consistency||In implantation bleeding, the bleeding is on and off.|
|Duration||The bleeding last for a few hours up to three days. (13)|
How long does implantation bleeding last?
Ideally, implantation bleeding last for a few hours up to three days (longest). Some women experience very light bleeding while others have heavy implantation bleeding. Nonetheless, it should not soak the entire sanitary pad. If the bleeding is more than the usual, then it should be a cause for concern. (14, 15)
Is Implantation bleeding dangerous?
Implantation is just a normal physiologic response of the body. It is an indicator that you are pregnant, which is a positive thing. It should not be a cause for concern. In fact, it does not possess any risk to the mother and the developing baby.
However, if the bleeding is heavy and longer than the usual, it isn’t considered normal at all. It could be a sign of something more serious. It could lead to miscarriage or ectopic pregnancy.
The latter is more likely to happen if the bleeding comes with other symptoms such as nausea with or without vomiting, one-sided abdominal pain, and dizziness. These things are a cause for concern and if you are feeling any of the following along with bleeding, then you need to consult your doctor right away. (16, 17, 18)
Is implantation bleeding a sure sign of pregnancy?
If you are planning to get pregnant, you might be on a constant lookout for implantation bleeding as it is one of the presumptive signs of pregnancy. However, the absence of implantation bleeding does not necessarily mean that you are not pregnant. Every pregnancy is unique and not all pregnant women have to go through implantation bleeding. Implantation bleeding happens because of the zygote’s attachment to the lining of the uterus.
To be sure, you need to watch out for other signs of pregnancy such as breast tenderness, nausea with or without vomiting (morning sickness), mood swings, fatigue, and sleepiness. Just because implantation bleeding does not take place does not mean you are not pregnant. On the other hand, excessive bleeding during pregnancy could indicate a miscarriage, ectopic pregnancy, or the egg does not have an embryo.
Again, it varies from one patient to another. Every pregnancy is unique because every person has a unique biochemical makeup. To be sure, you need to consult your doctor. Your doctor is the best person to help you with your concerns. (19, 20)
Managing implantation bleeding
If you are pregnant and you notice a blood stain in your underwear, you will surely panic and anxious. As much as possible, you have to remain calm. There is really nothing to worry, especially if you don’t experience any pain, abdominal cramping, or heavy bleeding.
Implantation bleeding is normal and would last for three days (maximum). If you feel like it is more than just implantation bleeding, then the best thing to do is to consult your doctor. The doctor will schedule an ultrasound to check on the developing baby inside the womb.
Bleeding related to implantation is treated as a part of the pregnancy. There is really nothing you can do about it. You cannot prevent it in any way. It is just a sign that tells you that everything is progressing the way it supposed to. Some women experience it while others don’t.
Just because you experience implantation bleeding does not necessarily mean that your pregnancy is abnormal. It is just a normal occurrence that could last for a few days. After that, everything will go back to the usual pregnancy pattern. (15, 18, 19)
To prevent any further complications, pregnant women are highly encouraged to follow normal pregnancy guidelines. These are the following:
- Avoid all forms of stress
- Do not lift heavy objects
- Avoid performing high-intensity activities
- Avoid using tampon during pregnancy
Implantation bleeding is not dangerous. It is a part of the normal pregnancy progression. It lasts for a few hours to up to three days. The volume is small that using a regular pad won’t be necessary. A panty liner is enough to absorb the blood.
If bleeding becomes heavy, lasts for more than three days, and comes with other alarming symptoms, then you need to see your doctor. Your doctor will rule out the underlying cause of bleeding and will determine the best course of treatment and management. (10, 11, 12)