Here’s What Your First Period After a Miscarriage Could Be Like

After your miscarriage, it’s normal to experience persistent spotting for a few days. That’s not your period — it is part of the miscarriage. That bleeding will last until your body has expelled the contents of your uterus.

It will take a few weeks before your period returns. “Most women experience a period roughly 4 to 6 weeks after a loss,” says Dr. Juan P. Alvarez, board certified reproductive endocrinologist at Fertility Centers of Illinois. The exact timing will depend on when your human chorionic gonadotropin (hCG) levels return to zero.

How long will it take for your hCG (the pregnancy hormone) levels to fall? That depends on how long your body needs to fully recover from the miscarriage. If your loss occurred after 12 weeks, your period might take longer to return than a loss before 12 weeks.

Your period’s return date will also depend on how long your natural menstrual cycle is.

What will that first period be like?

Your first period following a miscarriage may be different from your normal flow. Here are a few common symptoms to expect:

• heavier bleeding
• painful cramps
• strong smell
• longer length
• tissue or blood clots in your blood
• tender breasts

If you don’t ovulate before your first post-miscarriage period, your endometrial lining in your uterus will be thicker. That can cause heavier or longer bleeding.

Will I have PMS symptoms?

After a miscarriage, your body will go through some pretty big hormonal changes. This can cause symptoms similar to PMS, like mood changes and fatigue. It can also amplify feelings of emotional distress following your loss…

These feelings are very common. A research review showed that about 20 percent of people who have a miscarriage show symptoms of depression and anxiety. Emotional symptoms may linger for several months, so it’s important to take care of your mental health and lean on your support system if you can.

“You can successfully become pregnant as soon as 2 weeks after a miscarriage,” says Alvarez. Even though some experts recommend waiting up to 6 months, he explains that research shows that it’s safe to try again right away.

But just because it’s possible, it doesn’t mean it’s the right choice for you. You can work with your doctor to decide the timeline that works best for your situation.

“Emotionally, it can be beneficial to take a break from trying for a baby and focus on personal health, happiness, and well-being,” Alvarez says. “Time to grieve and process a loss can renew the emotional strength needed to try again.”

Waiting until you’ve had at least one full menstrual cycle can be helpful, too. That means you’ll have a normal period to reference when dating your pregnancy.

“Most [people] go on to conceive again and have a child, even those who experience multiple miscarriages, “ says Alvarez.

However, if you experience two or more miscarriages in a row he recommends contacting a reproductive endocrinologist. That’s a type of doctor who’s specially trained to treat infertility. These physicians can help you find out what’s affecting your ability to conceive.

“Depending on your individual diagnosis, medication, or fertility treatment may be necessary, which can significantly boost your chances of becoming pregnant,” Alvarez explains.

It’s important to prioritize your physical and mental health after an early pregnancy loss. Here are some tips for taking the best care of yourself post-miscarriage:

1. Have an appointment with your doctor. If you think you’ve experienced a miscarriage, try to have an appointment with your doctor as soon as possible. They can evaluate your symptoms and make sure you don’t have any medical complications. A doctor can also give you fertility advice.

2. Avoid sex until your symptoms go away. There are a few reasons you may want to abstain from sex for a while after a miscarriage.

• If you’re not emotionally ready to get pregnant again, it’s OK to wait until you’re ready.
• If you’re experiencing cramping, sex may feel painful.
• If you had a dilation and cutterage (D&C) procedure after your miscarriage, you may need to prevent infection.

3. Be patient with yourself. Show yourself some love as you recover. “It’s important to step back and take stock of emotional needs rather than rushing into trying again,” says Alvarez. “Give yourself time to mourn and process a loss.”

4. Prioritize self-care. Try to eat a balanced diet, get plenty of sleep, exercise regularly, and minimize your stress. Feel free to take the time to find out what makes you feel the best. Some people benefit from meditation or yoga, while others enjoy pursuing new hobbies or reading.

5. Talk about what happened. Miscarriage used to be a taboo subject — but keeping your pain a secret can increase your risk of developing depression. If you feel comfortable, talk with supportive friends or family members. You might also want to consider finding a therapist or joining a support group for people who have experienced a miscarriage.

There are some symptoms that you don’t want to ignore after a miscarriage.

If you’re showing symptoms of an incomplete miscarriage or serious infection

Call your doctor if you’re experiencing any of these symptoms:

• backache or back pain
• abdominal pain or cramping
• severe bleeding (enough to soak one pad per hour)
• diarrhea or pain when going to the bathroom
• dizziness, weakness, or fainting
• very strong-smelling vaginal discharge
• chills or fever

You could be experiencing an incomplete miscarriage. That’s when tissue from the pregnancy remains in your uterus, or there’s an infection.

If your period doesn’t come back

If your first period after a miscarriage is incredibly light or if it never comes back, call your doctor. Although it is rare, you could have Asherman’s syndrome, a scarring of your uterus that can result from a D&C or an infection of your endometrium.

If you’re showing symptoms of clinical depression

Symptoms can include:

• changes in your appetite
• fatigue
• irritability
• trouble sleeping
• loss of interest in activities you used to enjoy
• persistent feelings of sadness, hopelessness, guilt, or emptiness
• difficulties sleeping
• thoughts of suicide

Reach out to a healthcare or mental health professional. If you’re in crisis, call the National Suicide Prevention Lifeline at 1-800-273-8255.

If you’re feeling depressed, anxious, or overwhelmed after a miscarriage, there are lots of resources and support groups where you can talk to someone who understands what you are going through.

• The March of Dimes is one of the most well-known and well-established organizations focused on pregnancy health and they have a variety of free resources, including a free booklet for grieving families following miscarriages, stillbirth, or the death of a baby.
• HAND is a California nonprofit and resource network of parents, professionals, and supportive volunteers. They provide a variety of free services for people who experience a loss, including peer support groups, telephone support, and hospital visitation.
• Share Pregnancy & Infant Loss Support has been advocating for parents who experience a loss since 1977. They have chapters nationwide that run support groups. Check their website to find one near you.
• Fertility clinics and centers often have support groups too. For example, says Alvarez, “at Fertility Centers of Illinois, we host a free virtual pregnancy loss support group and invite anyone to join.”

Your period should return about 4 to 6 weeks after a miscarriage. When it comes, it probably won’t be the same as your usual flow. You’ll likely experience a heavier, longer, or more painful period.

Things should return to normal after one cycle.

If you didn’t have a D&C, you’ll likely be able to get pregnant again within one menstrual cycle. Keep in mind, though, it’s important to talk with your doctor about the timing that would be best for you.

If you need support while grieving your loss, there are a number of free resources available. You can also connect with your doctor about any questions or if you have any symptoms of an infection, like severe bleeding or fainting.