| It could have been one of a few things. It could have been an early pregnancy loss (miscarriage), a very heavy period, a symptom of ectopic pregnancy, endometriosis, or the expulsion of fibroid tissue. Sometimes, usually for older women, it is the expulsion of endometrial material during the hormonal shifts associated with perimenopause — the time of changes leading into menopause. To be more certain, you should have a gynecological visit to have your clinician make an evaluation. This can be especially important if tissue remains in the uterus that may cause infection. To help the clinician make an evaluation, save the tissue that is expelled and take it with you for your visit.
It is nearly impossible to determine what caused your experience without additional information and an examination. But it is important to have a pregnancy test done, even now, to make sure you are not pregnant. Pregnancy tests can also help detect ectopic pregnancies, which can be confirmed by ultrasound examination of the uterus. You should determine whether or not you have an ectopic pregnancy as quickly as possible.
Ectopic pregnancy is very dangerous, and it can be fatal if not treated. It is important for all women to know the signs:
- cramps and spotting
- vaginal bleeding
- severe lower abdominal pain on one side of the body
- nausea
- vomiting
- fainting spells
- dizziness
Women who have these symptoms should contact their clinicians or go to an emergency room immediately.
Pregnancy testing can also detect pre-existing pregnancies for some time after they have ended. The pregnancy hormone, HCG (human chorionic gonadatropin), can remain in the body for up to 60 days after an abortion or miscarriage. Similarly, HCG levels can be measurable for weeks after childbirth. If you are not and have not been pregnant, other possible reasons for the severe cramps and passage of tissue can be evaluated.
Early pregnancy loss, also known as spontaneous abortion, during the first 20 weeks of gestation, happens in 15-40 percent of all pregnancies. It often happens before women are aware that they are pregnant. In fact, most often women are unaware of early pregnancy loss because the amount of tissue lost is very similar to the flow of a heavy menstrual period.
As pregnancies go on, miscarriage becomes less and less likely. Later in pregnancy, of course, pregnancy loss is more likely to be observed and more likely to be upsetting because the woman is more likely to know she is pregnant and to plan on childbirth. Counseling for these pregnancy losses and evaluation for the outcome of future pregnancies can often be very helpful and reassuring.
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