What is implantation bleeding?
If you notice spotting or light bleeding several days before your period is due, it could be implantation bleeding. Spotting has many causes, so you might wonder how to recognize implantation bleeding. Before you reach for a pregnancy test, see if your symptoms and the timing of your spotting line up.
Implantation bleeding is light vaginal bleeding that sometimes occurs very early in pregnancy. Implantation bleeding can happen when a fertilized egg attaches, or implants, into the uterine wall. The egg attaches to the uterus anytime between 6 to 12 days after ovulation. This means if you ovulate on day 14 of your cycle, implantation could happen sometime between 17 to 26 days after the start of your last period.
As the fertilized egg settles into the uterine wall, this can cause the lining to slough off and result in spotting or light bleeding. Bleeding can also occur due to changing hormones related to early pregnancy.
Even though it's rare, if you have spotting a week before your period is due, you might wonder if it's implantation bleeding. Implantation bleeding can be a very early sign that you're pregnant.
How common is spotting in early pregnancy?
One small study showed less than one in ten women reported vaginal bleeding in early pregnancy. In most cases, the spotting occurred near the date their period was due. Spotting is even more common later in pregnancy. Up to 25% of women experience bleeding or spotting at some point during their pregnancy.
Spotting during early pregnancy could mean many things, including:
- changes in your cervix
- spotting caused by sex
- hormone imbalance
- infection
- early miscarriage
Spotting in early pregnancy can also be due to implantation.
How do I know if it's implantation bleeding?
Timing can be vital in knowing if your spotting might be implantation bleeding. Implantation typically occurs 6 to 12 days after ovulation, so spotting that happens as a result of implantation should happen in that timeframe or soon after that. For most women, this means the spotting would take place a week or just a few days before their period is due to begin.
Implantation bleeding can vary in appearance, but it's typically:
- light pink to brown
- free of clots
- a very light flow that you might only see when wiping
- short, often only a few hours and no more than a few days
You might have other early pregnancy symptoms, like fatigue and breast tenderness, at the time of implantation bleeding. Early pregnancy symptoms might raise your suspicions that your vaginal bleeding is due to implantation, but unfortunately, many early pregnancy symptoms are similar to premenstrual symptoms. The best way to know if you're pregnant is to take a pregnancy test.
When can I take a pregnancy test?
Home pregnancy tests measure the human chorionic gonadotropin (hCG) in your urine to detect pregnancy. Your body begins to produce hCG as soon as implantation occurs. The earliest you might have enough hCG in your system to get a positive pregnancy test is about eight days after ovulation. However, many pregnant women will not get a positive pregnancy test result this early.
The amount of hCG can vary due to many factors, including the timing of implantation. A week after ovulation, soon after implantation bleeding, hCG levels can be as low as 5 mUI/ML of hCG. At four weeks pregnant, at the time your period is due, your hCG levels can range from 10 to over 700 mUI/ML of hCG. Home pregnancy tests typically detect pregnancy at hCG levels greater than 20 mUI/ML.
Wanting to take a pregnancy test as soon as you experience possible implantation bleeding is understandable. If you choose to test as soon as you discover spotting, be aware that the earlier you test, the more likely you are to get a false negative. A false negative can happen when pregnant, but your hCG levels are not yet high enough to trigger a positive result on a home pregnancy test.
The best thing to do is wait a couple of days after seeing implantation spotting before taking a pregnancy test. This gives your body time to produce detectable levels of hCG. For the most accurate results, wait until your period is due before taking a home pregnancy test.
Medically Reviewed on 1/12/2022
References
SOURCES American Academy of Family Physicians: "Bleeding During Pregnancy – What's Normal?" Flo: "Period-Like Bleeding During Early Pregnancy: Is It Normal? Causes and Signs of Implantation Bleeding." Human Reproduction: "Vaginal bleeding in very early pregnancy." March of Dimes: "Bleeding and Spotting During Pregnancy." StatPearls: "Human Chorionic Gonadotropin." UCSF Health: "HCG blood test – quantitative."
UT Southwestern Medical Center: "How early can home pregnancy tests show positive results?"
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Think you might be pregnant?
Even with the most effective birth control methods, there’s always a chance for error. After all, it takes just one sperm to fertilize the egg. Finding out whether or not that’s happened is as easy as taking an over-the-counter (OTC) pregnancy test.
OTC pregnancy tests typically test your urine for a hormone called human chorionic gonadotropin (HCG). HCG is only present if you’re pregnant. The hormone is only released if a fertilized egg attaches outside the uterus or to your uterine lining.
There are different ways to collect your urine for the test. Depending on the test you choose, you may have to:
- collect your urine in a cup and dip a testing stick into the liquid
- collect your urine in a cup and use an eyedropper to move a small amount of fluid into a special container
- place the testing stick into the area of your expected urine stream so that it will catch your urine midstream
According to Cleveland Clinic, most tests are 99 percent effective if taken after a missed period. The best part is that you can do it in the privacy of your own home. Simply open the test, follow the instructions, and wait for the recommended amount of time to view the results.
After the recommended waiting time has passed, the tests will display your results in one of the following ways:
- a change in color
- a line
- a symbol, such as plus or minus
- the words “pregnant” or “not pregnant”
You should wait to take a pregnancy test until the week after your missed period for the most accurate result.
If you don’t want to wait until you’ve missed your period, you should wait at least one to two weeks after you had sex. If you are pregnant, your body needs time to develop detectable levels of HCG. This typically takes seven to 12 days after successful implantation of an egg.
You may receive an inaccurate result if the test is taken too early in your cycle.
Here are some signs that you should take a pregnancy test.
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One of the first and most reliable signs of pregnancy is a missed period.
If you don’t track your cycle closely, it might be hard to determine whether or not you’re late. Many women have a 28-day menstrual cycle. Consider taking a test if it’s been more than a month since your last period.
Keep in mind that your period can sometimes be delayed or skipped due to stress, diet, exercise, or certain medical conditions.
Also pay attention to your flow if you suspect pregnancy. It’s common to experience light bleeding or spotting in the early weeks as the egg buries deeper into the uterine lining during implantation. Take note of any difference in the color, texture, or amount of blood.
Contact your doctor if you have bleeding and a positive pregnancy test.
Implantation can also produce a feeling similar to menstrual cramps. In early pregnancy, you may feel this discomfort and think your period is just around the corner, but then it never comes.
Sound familiar? Take a test. Hormone levels vary by woman and by pregnancy.
As your pregnancy produces more and more estrogen and progesterone, these hormones start to make changes in your body to support the baby’s growth.
Your breasts may feel tender and appear bigger due to increased blood flow. Your nipples might hurt and the veins might look darker under the skin.
Because many women also experience breast discomfort in the days leading up to their period, this symptom isn’t always indicative of pregnancy.
Along with cramps and sore breasts, early pregnancy can cause:
- nausea
- food aversions
- exhaustion
- frequent urination
As the weeks go on, these symptoms may get stronger before your HCG levels even out late in the first trimester. You know yourself, so pay attention to your body. Any unusual physical symptoms could prompt you to take a pregnancy test.
Birth control pills, condoms, and other types of contraceptive devices don’t provide 100 percent protection from pregnancy. In other words, there’s always a slight chance of pregnancy, no matter how careful you are.
Despite your birth control preferences, consider taking a test if you experience any of the signs we’ve listed.
Human error or defects can also result in unplanned pregnancy. Birth control pills can be difficult to remember to take each day. According to Planned Parenthood, 9 out of every 100 women on the pill will get pregnant if they don’t take it as directed.
Condoms can break and tear or otherwise be used incorrectly. According to Planned Parenthood, nearly 18 in every 100 women relying on condoms for contraception get pregnant each year.
If you’re worried about contraceptive failure, ask your doctor about alternative contraceptive methods, such as an intrauterine device (IUD). According to Planned Parenthood, less than one out of every 100 women using an IUD gets pregnant each year.
Sexually active women in their reproductive years have a chance of pregnancy every month, even when using protection. There are certain signals your body might send that should prompt you to take a pregnancy test.
For the best results, take the test after you think you’ve missed your period. Test during your first morning bathroom visit, or hold it for several hours to increase the concentration of the HCG hormone that the test measures.
Testing early helps to ensure that you get proper care for yourself and, if applicable, prenatal care for your baby. In the event of a positive result, contact your doctor as soon as possible to discuss your options and potential next steps.