It can be difficult to tell the difference between a period and an early pregnancy loss, as they share some symptoms.
Miscarriage is fairly common in the first trimester. It happens in about 10% of known pregnancies.
In some cases, miscarriage can occur before you know you’re pregnant. If this happens, you might not notice anything different from your usual period.
The further along you are in a pregnancy, the less likely it is that a miscarriage will feel like a period.
Continue reading to learn how to tell the difference between an early pregnancy loss and a period, including specific symptoms to watch for, when to see a doctor, and more.
Telling the difference between a period and an early pregnancy loss is difficult because they share some symptoms. It may be impossible to know.
Shared symptoms
These symptoms may be due to an early pregnancy loss or a period:
- vaginal bleeding
- passing tissues or blood clots
- abdominal pain and cramping
- back pain
However, spotting or light bleeding during early pregnancy isn’t always a sign of miscarriage. If this happens, watch for any other unusual symptoms.
Period symptoms
Period symptoms vary. Between ovulation and menstruation, the hormones estrogen and progesterone
Period symptoms include:
- bloating
- breast tenderness
- fatigue
- constipation or diarrhea
- headache
- irritability
- appetite changes
- tension or anxiety
- mood changes
- trouble concentrating
- sleep problems
- less interest in sex
Periods tend to follow a predictable cycle, although not for everyone. If bleeding occurs earlier or later than you’d expect your period, it may be an early pregnancy loss.
Early pregnancy loss symptoms
An early pregnancy loss can cause these symptoms:
- cramping in your abdomen or lower back —this could start out like period cramps, but the pain typically worsens over time
- nausea
- diarrhea
- passing pink, red, or brown fluid, larger-than-normal blood clots, or tissue from your vagina that may resemble coffee grounds
- a gush of fluid from the vagina
- bleeding that eases after a few days but can continue for up to 2 weeks
A miscarriage can happen any time after fertilization. If you didn’t know you were pregnant, it would be easy to mistake it for a period. The further along a pregnancy is, the less likely it is that you’ll mistake a miscarriage for a period, as you may pass fetal or placental tissue.
During a miscarriage, bleeding gets heavier and lasts longer than a period. As your cervix starts to dilate, cramping may become more painful than typical period cramping.
See a doctor if you’re soaking through a tampon or pad every hour for more than two consecutive hours.
A chemical pregnancy is an early pregnancy loss at around 5 weeks or less. At this stage, a pregnancy is detectable with a pregnancy test but will not show on an ultrasound.
You may realize you’ve had a chemical pregnancy if you got a positive pregnancy test result, only to start bleeding some time afterward. A follow-up test may give you a negative result.
You may also notice that your cycle length has been different from usual. If your period was late and then you started bleeding, it may have been an early pregnancy. However, you can only know this if you got a positive pregnancy test result before you started bleeding.
Around half of all early pregnancy losses are due to chromosomal irregularities that prevent a fetus from developing.
Unexpected pain or excessive bleeding can be signs of an ectopic pregnancy. This occurs when a fertilized egg has implanted outside the uterus, possibly inside a fallopian tube. It’s a medical emergency, so you should see a doctor right away.
Call a doctor if you experience bleeding alongside:
- severe pain
- passing mucus, tissue, or large blood clots
- having uterine contractions
- fever or chills
If you believe you’re having an early pregnancy loss, ask your doctor the following:
- Should I collect a sample of blood or tissue? This isn’t always necessary.
- Should I go to an emergency room or make an office appointment?
- Is it fine to drive myself, or do you recommend against it?
If it appears that you’ve had a miscarriage, your doctor will want to perform a physical exam.
Be sure to discuss all your symptoms, including the amount of:
- bleeding
- clotting
- pain
- any tissue that may have been expelled
Testing may include:
- an ultrasound to check the uterus for signs of an embryo or a heartbeat
- a blood test to check for human chorionic gonadotropin (hCG), a substance that indicates pregnancy
Even after an early pregnancy loss, hCG may still be elevated for some time.
There’s no way to stop a miscarriage in progress. If your doctor determines that you’ve experienced a miscarriage, they’ll want to check for:
- signs of infection
- uncontrollable bleeding
- tissue that may be left in your uterus
It can take up to two weeks to completely expel the tissue naturally. Your doctor will review with you typical bleeding patterns to expect. If you have heavy bleeding lasting several days or any signs of infection, you may need medical treatment.
If your doctor isn’t sure that all of the pregnancy tissue has been cleared from your uterus, they may order an ultrasound to confirm.
Your doctor can prescribe medication, such as misoprostol (Cytotec), to increase uterine contractions to help you expel the tissue.
You’ll experience cramping and bleeding as you pass tissue and blood.
Most people pass the tissue within 24 hours after taking the drug. For others, it can take a few days to complete. Either way, it doesn’t require a hospital stay.
Your doctor may be able to prescribe pain medication to help ease your symptoms.
If your blood type is Rh negative, you’ll need an injection of Rh immunoglobulin. This may help prevent complications in a future pregnancy.
There are also a few surgical options to remove tissue from the uterus. This includes:
- Vacuum aspiration: Your doctor inserts a thin tube that contains a suction device into your uterus. This can be done with local anesthesia in your doctor’s office.
- Dilation and curettage (D&C): Your doctor dilates your cervix and then uses an instrument called a curette to scrape your uterine lining. This can be done at a surgical center or operating room on an outpatient basis. Regional or general anesthesia can be used.
Both of these treatments have been well-studied and are considered safe. They each carry a very small risk of serious complications.
What happens if you have a miscarriage and don’t go to the doctor?
If you suspect a miscarriage, it’s important to see a doctor for these reasons:
- They can ensure all the tissue has passed, as retained tissue can cause an infection.
- They can help manage the bleeding. Excessive bleeding can lead to anemia or other complications.
- They can provide advice and emotional support.
An early pregnancy loss and a period cause similar symptoms, so it can be difficult to tell them apart.
With an early pregnancy loss, the bleeding may be heavier and last longer. You may pass bigger clots, fluid, and other tissue.
The symptoms of a period may come on gradually before bleeding begins. They include bloating, appetite and mood changes, and breast tenderness.
It’s often impossible to know whether you’ve experienced a period or miscarriage unless you received a positive pregnancy test before bleeding began.
See a doctor if your pain or bleeding is excessive.