What should you know about hormones after miscarriage?

Hormonal changes can affect nausea, breast tenderness, tiredness and emotions after the pregnancy ends. Bleeding and cramps may continue for a while, and the next period may be earlier, later, heavier or different from usual. The timing depends on how the miscarriage was managed and whether pregnancy tissue remains. A transvaginal ultrasound may be used when clinicians need to assess the uterus or clarify whether the miscarriage is complete. Emotional recovery may not follow the physical timeline; grief, relief, anger and numbness can all occur.

Use the medicines and follow-up plan provided by your care team, and keep any recommended pregnancy-hormone tests or scans. Rest when needed, drink fluids and use sanitary pads if advised so bleeding is easier to observe. Ask when sex, swimming, exercise and trying for another pregnancy are appropriate for you. If tissue remains, medical management or surgical management may be discussed; each option has different practical considerations and should be chosen with your clinician.

Seek urgent care for heavy bleeding, severe or worsening abdominal pain, fainting, dizziness, fever, chills, foul-smelling discharge or feeling seriously unwell. Contact your clinician if pregnancy symptoms do not ease as expected, bleeding continues, or a pregnancy test remains positive during the advised follow-up period. Sudden severe pain with weakness or shoulder-tip pain needs immediate assessment.

How will we confirm that the miscarriage is complete? Do I need an ultrasound or hormone test? What symptoms should prompt urgent care, and when can I safely use contraception or try to conceive again?