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On breastfeeding. Missed periods. Ovulation test positive. Normal to get a period after a positive ovulation test?

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I have a 7 month old baby and am still breastfeeding (pumping at work and solids have been introduced). I was feeling abnormal (irritable, tired, nauseated) last Tuesday and being I haven't had a period yet, I took a pregnancy test that was negative. I then took an ovulation test that was brightly positive. I was nervous that I might have gotten pregnant from intercourse the previous Saturday and Sunday. However, yesterday it seems I got my period. It is very heavy with a lot of clots (as many clots, maybe more, as I saw in the early post partum period with all 3 births I've had). Historically no issues with a heavy period. So my questions are: Is this normal to get a period 5 days after a positive ovulation test? Is this okay to have as many clots, if not more, than even the early post partum? Would it be a possibility of having this many clots, given the timing of bleeding so close to positive ovulation test, due to implantation bleeding? Thank you for your time..
Posted Thu, 16 Aug 2012 in Menstruation and Miscarriage
Answered by Dr. Timothy Raichle 27 minutes later
Hello, I would be happy to help you with your question. Thank you for being patient.

It is not suprising at 7 months from delivery and at the point where you are naturally starting to wean from breast-feeding (to some extent) that you might start cycling. As prolactin levels start to drop, your cycle will often resume. With regard to your concern about pregnancy, and assuming that you are having unprotected intercourse, I will say that there is inherently a risk for pregnancy. The ovulation kits will turn positive right before and during ovulation, so intercourse in the days prior was probably pretty safe. In answer to your questions:

1. The bleeding is likely not related to a normal period. There may have been some buildup of the lining related to the start of a cycle, but no ovulation. When this occurs, it is not unusual to have breakthrough bleeding related to this excess buildup of the lining itself - I am saying that the bleeding is unrelated to evidence of recent ovulation, in fact.
2. The heavy bleeding could very well be related to this non-ovulatory buildup of the lining. If you are soaking through as much as a pad per hour, then you should call your doctor tonight. If it is heavy, but not this much, then I would definitely update them tomorrow and see if you need to be evaluated.
3. Given the negative pregnancy test, timing of intercourse, before the positive LH surge using the ovulation kit, and breast-feeding, I think that you are probably not pregnant. Implantation bleeding is associated with a small amount of bleeding. This does not sound like implantation bleeding.

So to summarize, this is probably related to irregular cycling and breakthrough bleeding related to natural weaning from breast-feeding. Your doctor should be updated tonight if it is as heavy as I described, and definitely in the morning. You might need a check of your blood counts and an ultrasound of the uterus. You can also discuss birth control pills as a way to slow down the bleeding. You should repeat the pregnancy test in 1 and 2 weeks from now.

I hope this answers your question. If you have more questions, please ask. If you are satisfied, please take a moment to leave feedback! Good luck!
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