Can you be pregnant and still have your period?

Written by Marion Goilav

Relecture professionnelle

Reviewed by Charline midwife

Relecture professionnelle

When women reach puberty, they begin to menstruate on a regular basis. This continues until the menopause. The only time a woman doesn't menstruate is during pregnancy. Yet many women don't suspect they're pregnant, because they continue to menstruate. So, can you menstruate and still be pregnant?

Is it possible to menstruate while pregnant?

Let's be clear from the outset: it's not possible to be pregnant and get your period at the same time. On the other hand, many women experience bleeding during pregnancy. As these losses are reminiscent of menstruation, the terms menstruation and pregnancy are associated. However, pregnant periods have nothing to do with the process of endometrial elimination at the end of each cycle. There are three reasons why a woman may "menstruate" while pregnant.

Early pregnancy

When metrorrhagia (bleeding between periods) occurs in the first trimester, it may have been caused by the implantation of the embryo in the uterus. This can result in bleeding similar to a pregnant period. The discharge is generally pink or brown and not very abundant. They are not painful and last 1 to 2 days.

You can also be pregnant and have an anniversary period. This bleeding occurs almost at the same time as your expected period. Here too, the discharge is light.

Bleeding in early pregnancy may be due to detachment of the trophoblast (future placenta). A decidual hematoma is formed, which in most cases resolves spontaneously.

When a woman suffers from benign cervical lesions, sexual intercourse and gynaecological examinations can also cause bleeding.

Although benign bleeding is common at the start of pregnancy, red bleeding should be investigated as it may be a spontaneous termination of pregnancy (generally referred to as a miscarriage). In addition, if red bleeding is associated with abdominal pain that doesn't subside with rest or painkillers, and if you haven't had a pregnancy ultrasound, it's essential to go to the emergency room to check that it's not an extra-uterine pregnancy.

Mid- and late pregnancy

Blood loss during pregnancy is generally contact bleeding. This can be caused by sexual intercourse or a gynaecological examination. They are more like spotting and are not dangerous to the health of either mother or baby. In this case, the bleeding is often light, often brown, and occurs within 48 hours of contact. Some women taking the pill don't realize they're pregnant. They continue to take their contraceptive and experience bleeding at the end of each cycle. It's important to remember, however, that these menstrual periods are artificial: they're known as "withdrawal bleeding". So for her, being pregnant and having her period seems perfectly possible.

Bleeding is one of the things we look out for during pregnancy. Unexplained red bleeding, even if it's painless and the baby is moving well, should be reported to the maternity emergency room.

After childbirth, it's normal to experience bleeding for several weeks. This is known as lochia. Lochia is not the period after childbirth, but the physiological bleeding and discharge of the post-partum period. What we'll call the first period after childbirth is the return of childbirth. This occurs at the earliest about 6 weeks after delivery (sometimes later if you're breast-feeding, and sometimes never if you're using progestin-only contraception).

A rarer case: pregnancy denial

Pregnancy denial occurs when a woman is pregnant without realizing it. Denial of pregnancy can be partial or total. In the first case, a woman will become aware of her pregnancy before giving birth. In the second, she becomes aware of the situation when she gives birth. In both cases, it seems impossible for the woman to be pregnant, often because she's on the pill. This means that her body shows no symptoms: no nausea or fatigue, and she gets her period while she's pregnant. It's also possible to experience pregnancy denial when you have irregular cycles, or even without contraception. Pregnancy denial can affect any woman in a situation where she has no idea that pregnancy is actually possible.

What's the difference between a pregnant period and bleeding?

It's not possible to be pregnant and have a period at the same time. Pregnant periods are actually bleeding, distinct from menstrual bleeding. "Pregnant periods" is even an expression that doesn't exist, because it's antinomic. There are three things you need to know to distinguish what's best called pregnancy bleeding:

  • The color of the "period": pregnant "periods" are often less abundant than normal periods. Bright red blood should prompt a visit to the doctor. Only lochia can be this color (sometimes darker), but it's nothing to worry about.
  • Duration of menstrual ble eding: Bleeding that is not a cause for concern during pregnancy is often short-lived. Sometimes just traces over 1 or 2 days, and therefore much shorter than periods outside pregnancy. This may be the case with anniversary periods, egg implantation or contact bleeding. If your bleeding is as long as a period during pregnancy, you should seek medical advice.
  • Volume: blood loss during pregnancy is very low. When the flow is abundantf the flow is heavy, you need to go to an obstetric gynecological emergency room.

What to do in the event of painful periods during pregnancy?

While bleeding during pregnancy is completely normal, it is imperative to consult your gynecologist when accompanied by pain. These symptoms may be a sign of miscarriage, molar pregnancy or ectopic pregnancy.

If the pain is very intense, you can go straight to the gynaecological emergency department. If you're unable to judge the severity of the pain because the bleeding is moderate, you can contact your usual health-care provider. And if he or she isn't available quickly for an opinion, you can take a teleconsultation to get an expert opinion without having to travel, in the first instance.

Pregnancy FAQs

How can you tell if you're pregnant even if you're menstruating?

The absence of a period is the most common indicator of pregnancy. In the case of a menstruating pregnant woman, other signs may point to pregnancy: extreme fatigue, tender breasts, nausea, headaches and changes in taste and smell. When in doubt about a possible pregnancy, the only way to find out is to take a pregnancy test.

Is it possible to be pregnant while menstruating?

The answer to the question of whether it's possible to menstruate and become pregnant is "no". However, there are a number of circumstances that can lead women to believe that they are menstruating and pregnant. This bleeding can be caused by various factors, such as an anniversary period, sexual intercourse or miscarriage.

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