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    Late period or miscarriage?
    Anon_183567 posted:
    The first day of my last period was 12/24/12. One thing led to nother and my husband and I had unproteced sex during my fertile period. About 6 or 7 days after I strated having a lot of period-like cramping. Based on the period I started on 12/24 I was not scheduled to start again until 01/21/13 and I only start cramping a day or two before my period starts. I was also experience symptoms that suggested a pregnancy (which would have been my 4th so I know how my body is when pregnant). I took a home pregnancy test 3 days before the expected start of my period in January and it came out negative. I toook another test on the day my period was supposed to start, 1/21/13. The pregnancy test was 2 lines is postivie, 1 line its negative. I took in the morning. It showed one line, then a second was starting to appear, then it disapeared. I figured it was an invalid test and disregarded it expecting to take another test this weekend then go to my doctor in the next week or two. I started my period (late) on 1/25/13 (yesterday).

    I had (have) no typical issues I usually get with my period so it took my by surprise because there was nothing suggesting my period was coming. Its a heavy period and passing large clots. Yesterday I was in the bathroom and could feel clots coming out (while on the toilet). Once finished, I go up to put my pants back on and another clot came out of me and fell on the bathroom floorl. It was dark red, the length of a Q-tip and the width of a green been. Today I've been passing cloths still but smaller. I've been cramping but I've been cramping off and on since around the 12th of this month; just 6 days after unprotected sex with my husband.

    I have 3 kids and to my knowledge, never experienced a miscarriage. I have heard that woman who have late periods could actually be having a miscarriage, they just didn't know they were pregnant. The second pregnancy test took that look like it was a positive then went back to a negative makes me wonder if there was a pregnancy, but not sure. Could this be a miscarriage? If I made an appointment with my doctor, could they take a blood test to determine if there was a pregnancy? I'm bleeding now so obviously a pelvic exam wouldn't happen. Any suggestions?

    I never told my husband I thought I was pregnant and honestly wasn't expecting him until after I went to the doctor. Now I'm not sure what I should say or if there is anything to say. Any suggestions please.
    Anon_183567 responded:
    I forgot to mention, I am also having a lot of low back pain. The blood clots (or tissue, not sure what the correct term is) has finally stopped this evening. Thanks again
    Jane Harrison Hohner, RN, RNP responded:
    Dear Anon: Most commonly, when we send such specimens to the lab, the report returns as: white blood cells, red blood cells, fibrin, and other components of uterine lining tissue. It can look different as it is more solid than the liver-like consistence of blood clots. Many women worry that this is linked to a missed miscarriage, but that is not the usual explanation. If this is a concern to you than a sensitive pregnancy test can be done. This is usually a blood test. The most conclusive way to confirm a miscarriage is to have sequential blood pregnancy tests which show dropping HCG levels in amounts which may be too low for a standard urine test to detect. On the rare chance that the woman has passed a molar pregnancy, blood HCG levels are still usually detected.

    Some home pregnancy tests (HPT) can be as sensitive as those urine tests used in GYN clinics. The package would make reference to being sensitive to a little as 20 units of HCG in the urine. One of the problems with some brands is that, if left to sit longer than the "read now" time one can get a false positive which then seems to disappear.

    You are absolutely dog the correct thing in seeing your GYN for the most "for sure" answer. ...Glad the symptoms finally started to slack off.

    mschandalyn replied to Jane Harrison Hohner, RN, RNP's response:
    my 17 year old daughter had unprotected sex with boyfriend a
    couple a months ago. i took herr to get on birth control the
    depo shot. her periods been normal she say but this month
    she been bleeding since january the 15th heavywithclots
    tlkittycat1968 replied to mschandalyn's response:
    If your daughter has been bleeding for 15 days, it's time to see a doctor.
    AimeeV replied to Jane Harrison Hohner, RN, RNP's response:
    Hi Jane,

    Thank you for this valuable information. For the last decade or so, I have had light but very painful periods with solid masses the color and consistency of liver as you have described above. My periods were so painful I would break out in cold sweats and have nearly passed out. I have been diagnosed with ovarian cysts (which explains the heavy pain) and have had ovarian cysts removed, but are the liver-like "clots" a cause for concern? Would that affect my fertility at all in the future?

    Thanks in advance for your advice and input.
    Jane Harrison Hohner, RN, RNP replied to AimeeV's response:
    Dear AimeeV: The usual explanation for liver-like clots is a heavier type of flow. There is an enzyme produced by the lining of the uterus designed to keep menstrual blood from clotting. This allows the menstrual fluid to more readily pass out of the tiny cervical canal and into the vagina. When a woman is bleeding very heavily during her period the amount of flow surpasses the amount of enzyme--thus leading to passage of large clots. However, the action of this enzyme is localized to the inside of the uterus so it should not have anything to do with inability of other blood to clot.

    Large clots do not predict problems with fertility. Several other things you have mentioned MIGHT have an impact on
    future conceptions:

    1. Frequent ovarian cysts large enough to require surgical removal---IF you have polycystic ovarian syndrome (PCOS) that can decrease frequency of ovulations making it harder to conceive. Yet, women with PCOS tend to have multiple, small ovarian cysts ("string of pearls") rather than large dominant cysts.

    2. Extremely painful periods---IF your very painful periods are caused by endometriosis ("endo"), then endo can decrease fertility by several mechanisms. Yet, severe cramps can also be caused by increased production of prostaglandins by the uterine lining. This does not impact fertility.

    Prostaglandins create both the cramps of labor and menstrual cramps by making the uterus contract. Common cramps may start prior to the onset of flow and usually last 72 hours. There are also receptor sites for prostaglandins in the bowel and central nervous system. Thus prostaglandins can produce not just cramps but also nausea/vomiting, diarrhea, headaches, and other "flu-like" symptoms. Ways to block prostaglandins can include BCPs, or anti-prostaglandin drugs (eg ibuprofen, naproxen sodium, ketoprofen, etc.). Some alternative healthcare providers such as naturopaths stress using of Omega 6 fatty acids in dietary choices, and cramp bark.

    Aimee, your best bet for getting the most exact answer about the cause of your super painful periods is to see a GYN or your local family planning clinic. It is worth considering a consult--especially if there is a way to decrease the pain.


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