How long after a missed period does implantation occur

When you’re actively trying to get pregnant, those two weeks between ovulation and a positive home pregnancy test (or your period) can seem much longer. If you’re like most women, you’ll spend them hyper-aware of every ache, twinge and craving your body has, wondering whether it’s an early sign of pregnancy.

One of the most telltale symptoms of pregnancy is bleeding. If you do have some light spotting, does it mean anything?

While it can be hard to tell, many women who go on to have healthy, normal pregnancies have what’s called implantation bleeding around the time that their embryo lodges itself into the side of the uterus.

What is implantation bleeding?

Implantation bleeding is light bleeding or spotting that occurs between seven and 14 days after fertilization.

After ovulation and at the moment an egg is successfully fertilized by a sperm in a fallopian tube, the embryo starts dividing and growing. At this time, the inner lining of the uterus, called the endometrium, starts to change. It's already been thickening throughout the menstrual cycle, but it’ll need to grow and mature even more to protect and nourish an embryo.

Around five to six days after fertilization, the quickly growing embryo has moved down the fallopian tube and into the uterus. It’s starting to need more nutrients, and the endometrium has filled in enough to support it.

Next, the embryo attaches itself to the endometrium, where it becomes reliant on a mother’s body — for the first time — for nutrients and oxygen. When the embryo implants, it can disrupt tiny blood vessels in the spot it burrows into. This won’t cause any problems (the endometrium recovers!) but some women will experience light bleeding, from pinkish or red to brown discharge.

When does implantation bleeding happen?

So-called implantation bleeding will likely arrive earlier than your expected monthly menstrual period, usually around seven to 10 days after fertilization or conception.

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Signs of implantation bleeding

These are some of the most common implantation bleeding symptoms:

Light bleeding or spotting that some women say is different from normal period bleeding because the blood is darker
Mild cramping
A woozy feeling
Swollen breasts
Headache

Implantation bleeding vs. period bleeding: How to tell the difference

Since implantation bleeding is a symptom that can often occur before you test positive on a pregnancy test, it can be hard to know whether light bleeding is an early sign of pregnancy or just normal spotting leading up to your period. And unfortunately, there’s no conclusive way to find out.

The best way to know whether you’re pregnant or not is to wait a few more days and take a pregnancy test. The timing of when you last had sex might also help you figure it out. If it’s been more than two weeks, it’s unlikely that any spotting you're having is implantation bleeding.

About a third of women who report having experienced implantation bleeding often describe it as distinct from their usual premenstrual spotting — some say the blood is darker and not as red compared with normal period blood. Others have mild cramping at the same time as the spotting.

But for many women, the two types of bleeding aren’t different at all. So you’re not alone if you assume that some spotting is implantation bleeding and get your period a few days later, or if you assume that implantation bleeding is normal spotting and end up being pregnant!

How long does implantation bleeding last?

Implantation bleeding usually only lasts one or two days.

When to call the doctor

Light bleeding during pregnancy — even at times other than implantation — is often normal. Causes can include mundane things like irritation of the cervix following a pelvic exam, sex or infection of the vagina.

But because bleeding following a positive pregnancy test can sometimes be a sign of ectopic pregnancy, molar pregnancy or other early miscarriage, you should always call your medical provider if you experience it so you can talk through any other symptoms. Try not to worry too much though. Chances are good that if the bleeding is light and doesn't last long, everything is fine.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You're Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.

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Late Implantation Bleeding and Effects on Pregnancy

Disclaimer: Please note that this blog is for educational purposes only, it includes general information on health-related topics. Women’s Healthcare of Boca Raton is giving medical advice to Patients Only. Follow this link to request an appointment with Dr. Ellman.

Late implantation bleeding, or an early sign of pregnancy happens during the first trimester. It occurs when the fertilized egg implants itself in the uterus. Implantation spotting does not occur until about week six of a woman’s cycle and should be lighter than your usual period. However, some women notice that late implantation bleeding can be just as heavy or even heavier than their regular cycle.

Many women are rightfully concerned when they experience this type of bleeding, but it doesn’t always have to be a major cause for concern.

Still, if you have any concerns and wish to learn more, it’s always a good idea to visit your nearest Women’s Health Clinic.

What is Late Implantation Bleeding?

This type of bleeding, also called “breakthrough bleeding,” is a common condition many women experience during their first trimester. Some women mistake it for a period because of its timing and resemblance to a light flow. Still, the difference is that late implantation occurs around week 6 or 7 of pregnancy. In contrast, a typical period usually begins two weeks after ovulation, putting it at about week 4 or 5 in the pregnancy cycle.

Women who have been trying to get pregnant may not realize they are pregnant when they have this type of bleeding. In fact, late implantation can be one sign that leads them to test for pregnancy.

A woman who experiences a heavy flow of late implantation bleeding should immediately see her doctor to make sure it does not signal a miscarriage. Most miscarriages occur within the first trimester, and very early pregnancy symptoms are often missed by women because they do not recognize them as signs of pregnancy.

Late Implantation vs. Periods

The time of the menstrual cycle can vary for women. For some, periods might occur later than the expected date because of stress or other factors that affect menstruation (such as diet or exercise regimens). However, late implantation in pregnancy happens closer to the expected time of menstruation.

Another difference between the two is that instead of being caused by low progesterone levels, as seen in a menstrual period, this type of bleeding occurs because the fertilized egg has implanted itself on the uterine lining. A missed period is different because it is caused by a lack of progesterone. Often, periods are missed due to pregnancy, but this does not necessarily mean that pregnancy has occurred.

One should seek medical attention if the bleeding lasts for more than several days or if other symptoms occur along with the bleeding, such as severe cramping, abdominal pain, fever, or chills. Pregnancy can be ruled out if menstruation occurs outside of the usual time frame for your cycle. To be sure, you should always take advantage of OBGYN services in Boca Raton or take a home pregnancy test.

What Is Late Implantation Caused By?

The cause of late implantation bleeding is still not clear, but it might happen when an embryo attaches to the uterine lining in the wrong place and begins to grow incorrectly. This can cause a small amount of bleeding as the uterus begins to shed itself of this misplaced tissue.

Unlike a regular period, which occurs when estrogen and progesterone levels drop after ovulation, a woman experiencing late implantation in pregnancy will not have lowered hormone levels.

In fact, her hormone levels may be slightly higher because the embryo uses the estrogen created by the corpus luteum, which implants itself in place of a follicle after ovulation occurs.

What Is Late Implantation False Cauterization?

One cause of late implantation bleeding can be due to false cauterization. This happens when an embryo implants itself in the wrong location because it cannot find enough blood supply to continue growing.

The embryo then grows, using the nearby blood supply for its own needs and blocking it from the parts of the uterus that need it. This can cause pain and bleeding.

Are There Other Risks?

Late implantation bleeding is not considered to be hazardous to your health. However, if you experience any of the symptoms listed above or an increase in abdominal pain, you should consult your obstetric specialist immediately.

Late implantation bleeding occurs frequently enough among women of reproductive age that doctors have come up with general treatment guidelines rather than case-by-case terms for handling this type of bleeding.

Doctors often recommend removing uterine tissue left over from implantation through either dilation and curettage (D&C) or suction curettage (sucking the tissue out with a tube). They may also recommend medication to help the uterine lining shed itself.

How Does Late Implantation Bleeding Affect Pregnancy?

Many women go through implantation bleeding early on in their pregnancy and remain unaffected in later stages of pregnancy. Essentially, a high-risk pregnancy doesn’t always have to be caused by this type of bleeding.

Some doctors may see the presence of implantation bleeding as a sign that the embryo has attached itself to the uterine lining incorrectly and potentially damaged the placenta. If this happens, it could be problematic for the developing fetus and increase the chances of miscarriage and other problems, such as preterm birth or low weight at full-term birth.

Furthermore, if an embryo attaches itself too deeply into the uterine wall, there is more risk of having complications with growth because some blood vessels may become blocked. The woman’s body will try to compensate by increasing additional blood supply. Doctors call this process “hypervascularization of the decidua basalis.” If this process continues, uterine cancer becomes a risk down the road.

Some research even suggests no increased risk of preeclampsia for women who had experienced implantation bleeding. However, it does note that rates of preterm birth and low-birth-weight infants were higher in women with late implantation in pregnancy than those without it.

How Can Late Implantation Bleeding Be Prevented?

There are some steps you can take toward preventing late implantation bleeding before you even conceive. First, you should seek treatment for current conditions or infections so they do not become worse. Once you become pregnant, you should continue to follow routine prenatal care guidelines from our Women’s Health Clinic to help ensure a healthy pregnancy.

Early diagnosis of problems such as ectopic pregnancy and miscarriage may also help prevent late implantation bleeding due to false cauterization. If you suspect that you’re starting to experience implantation bleeding, here’s how you can manage.

Avoid washing the vulva or inserting foreign objects into the vagina until you can see a doctor because both things can introduce bacteria into the cervix and increase the chances of an infection. You should try using a sanitary pad in order to slow blood flow while waiting for medical attention instead of using cups or tampons.

Conclusion

Although late implantation bleeding is usually considered a normal part of early pregnancy development, it can also indicate problems. Women who experience this type of bleeding should see a doctor immediately to ensure that nothing more serious is going on. The risks associated with experiencing implantation bleeding depend largely on your general health and any other relevant medical conditions at the time.

What are your thoughts on this issue? Have you experienced it before? We’d love to hear your opinion when you book your next appointment at (561) 465-8800.

Dr. Ellman is a Board Certified OBGYN who established his medical practice in South Florida over 25 years ago. His office, Women’s Healthcare of Boca Raton, is located in Boca Raton, Florida at West Boca Medical Center. Dr. Ellman attended Albert Einstein College of Medicine of Yeshiva University, where he received his medical degree. He went on to intern at Beth Israel Hospital in Boston- an affiliate of Harvard Medical School- and continued his residency at North Shore University Hospital in Manhasset, New York- an affiliate of Cornell Medical School.

Dr. Ellman has practiced Obstetrics and Gynecology in the Boca Raton area since 1995. In addition to treating patients at West Boca Hospital, Dr. Ellman also treats patients through his own private practice, Women’s Healthcare of Boca Raton, located on the West Boca Medical Campus.

Published On: February 1st, 2022

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What are the signs of successful implantation?

Implantation is an essential early stage in conception, when cells attaches to the uterine wall. Signs of implantation include bleeding, cramps, discharge, and breast tenderness, and these can be early signs of pregnancy.

Can implantation take place 4 days after missed period?

Implantation itself usually occurs between 6 and 10 DPO, often called the window of implantation. Therefore, it's unlikely that you'll have experienced a complete implantation at 4 DPO. But the fertilized egg might have already reached the uterine cavity, which is where implantation will begin soon.

How late can implantation bleeding occur?

Implantation that occurs on the late end of the spectrum is known as late implantation. The spot where the embryo attaches itself inside of the endometrium can disrupt some blood vessels, which may cause some light bleeding anywhere from five to 10 days after conception, but before your period would typically occur.