Heavy bleeding and pregnancy: what to do

Bleeding in early pregnancy can have different explanations, including changes at the cervix, miscarriage or ectopic pregnancy. Bleeding alone cannot show whether a pregnancy is continuing or where it is located. Outside pregnancy, heavy flow can be linked with fibroids, adenomyosis, polyps, hormone-related conditions or changes in the uterine lining. A home pregnancy test and clinical assessment give more useful information than judging the bleeding by appearance. If you recently gave birth or may have conceived, tell the clinician when that happened.

Take a pregnancy test if pregnancy is possible, following the product instructions, and arrange medical advice when bleeding is heavy, persistent or accompanied by pain. Note the start time, flow, clots, one-sided pain, shoulder-tip pain, dizziness and any test result. Use pads while seeking advice if you need to monitor bleeding. Avoid taking medicines marketed for period bleeding until a clinician or pharmacist confirms they are appropriate when pregnancy is possible. A clinician may arrange repeat testing, examination or an ultrasound depending on symptoms and timing.

Call emergency services or attend urgent care for severe or one-sided pelvic pain, shoulder-tip pain, fainting, marked dizziness, heavy rapidly increasing bleeding, or feeling pale and weak. These symptoms can signal a serious pregnancy complication and should not wait for a home test result. Seek prompt advice for any bleeding with a positive pregnancy test.

Could I be pregnant, and do I need repeat testing? What symptoms would make ectopic pregnancy or miscarriage more concerning? Which medicines are safe while pregnancy is possible? If the test is negative, what could explain my heavy periods?