Dear Doctor,

I suffered a miscarriage after a misfortune at home about a month ago and I’m just trying to get back to normal physically and emotionally. The pregnancy was in its 8th week. I’m curious, however, about when my menstrual cycle will return and when it is safe to have intercourse again. I also plan on trying to have another baby. How long should I wait? I seem to be healing quite well but I want to be on the safe side.

Lucy

Dear Lucy

I am sorry for your loss. Usually a miscarriage is very traumatic both physically as well as mentally for any woman. Normally, it takes about four to six weeks for periods to resume after a miscarriage. It also depends on multiple factors. If abortion occurs in early pregnancy, it may take four to six weeks. However, in case of a miscarriage later in the second trimester, it may take two to three months. If the miscarriage occurred due to hormonal disorder, it may take longer depending on an underlying disorder. It also depends on how regular the menstrual periods were before pregnancy and the abortion happened. If periods were irregular, then it may take longer to resume or it may continue to be irregular, hence, not coming back in expected time.

When conception occurs, the levels of human chorionic gonadotropin (HCG) rise. Detection of HCG in urine forms the confirmatory test of pregnancy. After abortion, periods start when HCG levels are at zero. Also, the periods, when resumed, may not be the same as before. One may experience heavy bleeding with abdominal pain and muscle cramps in the legs. Sometimes there may not be any bleeding, just some spotting. Regarding sex, it depends on one’s sexual habits. But it is better to avoid it for at least two to four weeks after a miscarriage to avoid any trauma to the tender genital and reproductive organs.

Try to get over this traumatic event. It is usually advisable to avoid pregnancy for at least four to six months after a miscarriage as this gives the body sufficient time to recuperate after a miscarriage and prepare for the next pregnancy. At the beginning of the next pregnancy, it would be better to be cautious. Avoid any heavy work, exertion and physical/mental stress. Avoid alcohol and smoking, if you indulge in them. If there is a pelvic infection, get it treated. Diabetes, if present, should be well controlled. It would be prudent to get a gynaecological examination done as well as a pelvic ultrasound done at beginning of the next pregnancy to ensure it is carried out smoothly.

Dr. Rachna Pande

 Internist

E-mail- rachna212002@yahoo.co.uk