Implantation Bleeding vs. Menstrual Period: Key Differences
Comparison Table
| Feature | Implantation Bleeding | Menstrual Period |
|---|---|---|
| Timing | 6–12 days post-ovulation (around day 20–26 of 28-day cycle) | Day 1 of cycle (if no pregnancy) |
| Duration | Few hours – 2 days (rarely 3) | 3–7 days |
| Flow | Spotting only (few drops, on wiping) | Progressive flow, may have clots |
| Color | Pink, light red, brown (old blood) | Bright red → dark red → brown |
| Cramping | Mild, brief twinges | Moderate-severe, cyclic |
| Pattern | Intermittent, stops spontaneously | Continuous, tapers |
Critical Distinction
Implantation bleeding occurs before a missed period; it does not occur during an established pregnancy. Any bleeding after a positive pregnancy test warrants evaluation (threatened miscarriage, ectopic, subchorionic hematoma).
Confirmation
- Wait for missed period → urine hCG test.
- Serial quantitative β-hCG (doubling every 48 hrs in viable pregnancy).
- Transvaginal ultrasound at 5.5–6 weeks gestational age.
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