Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
145 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

Had a miscarriage. During periods blood comes out only while urinating. Scan showed no cysts. Underlying cause?

Answered by
Dr. Aarti Abraham


Practicing since :1998

Answered : 6011 Questions

Posted on Fri, 24 May 2013 in Menstruation and Miscarriage
Question: Hi. I recently had a miscarriage at 5 weeks. I am 34 and this was my first pregnancy. For the last 18 months I have experienced a change in my menstruation. It sounds weird but the blood only comes when I urinate during my period. So there is no need for me to wear any tampons or sanitary pads. I had a scan some time ago and they could see no cysts or any abnormalities. Is there something wrong and could this have caused the miscarriage. What can I do?
Answered by Dr. Aarti Abraham 44 minutes later
Thanks for your query.
I will deal with your query in two parts.

Question 1 - Why would you have had a miscarriage ?

There could be the following reasons for this :
1. Most common cause of pregnancy loss is genetic causes. There could be a chromosomally ( genetically ) abnormal fetus which did not develop normally and miscarried. For this, ideally the aborted tissue should have been sent for a genetic analysis. If that was missed, you and your partner should go for a karyotype.
2. Intrauterine infections - Get yourself checked for STDs, Rubella, toxoplasmosis, cytomegalovirus etc.
3. Abnormalities of size and shape of uterus can lead to miscarriage.
4. Autoimmune disorders - get laboratory evaluation for antiphospholipid antibody syndrome.
5. Hormonal imbalance - this could be the common link between your scanty periods and the miscarriage. When hormonal levels are deranged, you fail to have normal periods, and normal ovulation. Thus the egg formed is defective and can lead to abortion. Also, when hormonal levels are inadequate, the growing embryo fails to receive proper support, leading to abortion.
6. Routine tests like complete blood count, blood group , liver and renal function tests etc - rare blood group incompatibility etc can be a cause.

At 34, the egg formation is suboptimal, and the abnormalities in egg formation increase, so maternal age is a contributory factor incriminated in abortions.
For future conceptions, please consult a Genetic counsellor / high risk pregnancy expert first, who would give you a comprehensive check up and testing and then treat you accordingly before going for planning a pregnancy.

Question 2 - Why would you have a scanty menstrual flow ?

1. Anxiety, stress, weight gain or loss rapidly, hectic travelling, job or personal traumas, ingestion of hormonal medications or other medications that affect the menstrual cycle, recent illness, fever etc = all these can reduce the menstrual flow.
2. Polycystic ovarian disease - here the hormonal imbalance leads to formation of multiple follicles in the ovary, but none mature. So the woman experiences delayed and scanty periods, and defective ovulation. Get yourself tested with the following investigations - FSH, LH, PROLACTIN, TSH, FASTING SERUM INSULIN, GLUCOSE TOLERANCE TEST, SHBG, ADRENAL HORMONES etc. in addition to a pelvic transvaginal ultrasound.
3. Decreased ovarian reserve - This is the opposite end of the spectrum , where due to rapid ageing, the ovary loses its capacity to produce eggs, and those which are produced, are also suboptimal. AMH, FSH and antral follicular count are the tests to diagnose this.
4. Endometrial disease
5. Thyroid hormone dysfunction.

SO, your menstrual irregularities and the miscarriage COULD be related, because the causes overlap and ultimately have a bearing on your health , well being and reproductive ability.

Please consult a gynecologist / High risk pregnancy expert for thorough investigations and evaluation before embarking on your next pregnancy.
Have a healthy and active lifestyle, take regular folic acid supplements, maintain an ideal BMI and stay positive.
All the best for your future pregnancy.

Take care, and feel free to discuss further.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Aarti Abraham 23 minutes later
Thank you for your response. I would not say that my flow is scanty. I still have quite a normal flow. It is just that it does not flow out by itself. Only when I go to the toilet. When I do go there is quite a lot of blood and it is like normal menstruation blood. Red and thick.

I was told that at 34 I was still well within the optimal age for conception. Only after 35 does it start to become more difficult. Not impossible but more difficult. From your analysis I now feel that I might not be able to conceive successfully. Is that your feeling?

As I said I have been tested and I have no indication or any signs of:
- Polycystic ovarian disease
- Endometrial disease
- Thyroid hormone dysfunction

All these have been tested.

Could it be that this was just a once of fluke?
Answered by Dr. Aarti Abraham 4 minutes later
There is no reason why you should not be able to conceive succcessfully.
YOu are most probably having scanty periods, as in normal flow, your pad or tampon would be soaked by itself, instead of the flow being evident only when you use the washroom.
Yes, the miscarriage could be an isolated event also, but at 34 years, you would do well to have a thorough evaluation and then plan a pregnancy, to increase your odds of a successful conception.
If you have been screened for the 3 conditions mentioned, get yourself worked up for the rest of the list, just to be on the safer side.
Please stay positive, as the main culprit for both menstrual irregularities and pregnancy losses is stress, which negatively impacts the hormonal axis.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

Share on

Recent questions on  Folic acid

doctor1 MD

HI, My brother has been diagnosed with PsA, he has psoriasis from past 4 yrs but it showed only on the middle fingure on one hand. He was detected...

doctor1 MD

I have recently moved from Minnesota to Arizona. I have a history of ankle swelling, along with tingling and sharp shooting pains in my feet. My...

doctor1 MD

Due to increase in weight for past 1 year i am getting irregular periods.. Before that for me it was 32 day regular interval cycle.. Went to...

doctor1 MD

Hi doctor. I have had a miscarriage last year and i am trying to conceive again now. My gynae suggested i take osure, aspimed, folic acid and...

doctor1 MD

I am 14 weeks pregnant with twins. For the past 3 days am having severe shooting pain in my arms and shoulders. It started with left hand now moved...

doctor1 MD

My husband has had these symptoms for over a year: extreme fatigue , dizziness & slight headache. These symptoms have come and go all this time. he...

doctor1 MD

what should a pregnant woman do during pregnancy so she can have normal delivery?