Expert: Doctor Early Options - 7/30/2011

Question
QUESTION: Hello Doctor,
On 9/6/2011 I was less than a month pregnant when i had my medical abortion by taking cytotec.
I had bleeding for few days with cramps and little clots! later on i have experienced spotting that stopped in a matter of 2 weeks. On 22/7/2011 i got my period, there were very bad cramps alot of clots and heavy bleeding! this kept going for 2 days then the bleeding became normal less clots,, however, each day i get 2-3 hours of bad cramps that cause me to bleed too much then it stops. Cramps and bleeding only reside when i take voltareen 100mg anally. I have tried many painkillers and none have worked with those cramps like voltareen.
I am very concerned about this cramping,for the past few days no clots come out and its only brown-red blood. It has been a week now and i want to know what is going on and when might this stop!

ANSWER: It has been almost 8 weeks since you did the medical abortion.  It can be normal that the first period is heavy.  The cramping is normal.  The uterus is just squeezing out any remaining tissue and prevent heavier bleeding by contracting.  If this continues, you should have an ultrasound.  You could have a retained corpus luteum cyst that causes cramping.  Sometimes, a clot of blood can cause cramping and heavier bleeding. If my patients have these symptoms, I just have them come to the office for an ultrasound.   

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QUESTION: Okay so for now should i change the painkiller?? My period normally is five or six days and today is my seventh day! i am outside my country for now and I am going to travel on Wednesday 3/8/2011,, until i travel I wont be able to check up with any doctor.
So do you have any advice you can give me??I heard that it is normal for you to have a 2-week period post abortion and abnormal cramps! May i remind you those cramps come only few hours a day, blood comes out then the rest of the day its almost spotting! any advice?

Answer
Until you get back home, just continue the pain medication.  If it is only a few hours, this can be normal.  Cramping as I said is the way the uterus prevents clots from remaining inside and causing more problems.  Just stay active.  Exercise is beneficial.