Is the bleeding I'm experiencing considered a period or when should my period come, and should I test for pregnancy again?

Assessment of Bleeding After Progesterone Vaginal Pessary Use

The bleeding you're experiencing is likely withdrawal bleeding from discontinuation of progesterone pessaries, not a true menstrual period. You should take another pregnancy test in 1 week if bleeding remains minimal or stops completely. 1

Understanding Your Bleeding Pattern

• The light bleeding/spotting with a single clot on October 21-22, followed by brown spotting on October 24 after stopping progesterone pessaries on October 16, is consistent with progesterone withdrawal bleeding 1
• This pattern of bleeding is different from a typical menstrual period, which tends to be heavier and more consistent 2
• The 14.5mm endometrial thickness seen on ultrasound on October 20 suggests the endometrium was still under hormonal influence 1

Why This Is Likely Withdrawal Bleeding

• Progesterone vaginal pessaries maintain the endometrial lining, and when discontinued, can cause withdrawal bleeding similar to what happens when stopping hormonal contraceptives 2
• The timing of your bleeding (5 days after stopping progesterone) is consistent with withdrawal bleeding rather than a true menstrual period 1
• The light/spotting nature of the bleeding further suggests withdrawal bleeding rather than a full menstrual period 2

Next Steps

• If you are trying to conceive:

  • Take another pregnancy test in 1 week if bleeding remains minimal or stops completely 1
  • Pregnancy tests can sometimes be negative early on, especially if implantation occurred later than expected 3
  • The negative pregnancy test on October 18th (15 days after ovulation) is generally reliable, but given the progesterone supplementation and minimal bleeding, a follow-up test would be prudent 1, 3

• If you are not trying to conceive:

  • Your true menstrual period should start within 2 weeks of stopping the progesterone pessaries if you are not pregnant 1
  • If no period occurs within 3 weeks of stopping progesterone, a pregnancy test is recommended 1

Important Considerations

• The progesterone pessaries you used from October 4-16 could potentially delay your normal menstrual cycle 2
• Ultrasound findings of a 14.5mm endometrial thickness without other abnormalities could be consistent with either early pregnancy or hormonal effect from the pessaries 1
• Brown spotting typically represents older blood and is common during withdrawal bleeding 3

When to Seek Medical Attention

• If bleeding becomes heavy (soaking through a pad/tampon every hour for 2+ consecutive hours) 1
• If you experience severe abdominal pain 1
• If bleeding continues intermittently for more than 7 days 3
• If you develop fever or other concerning symptoms 1

Remember that the timing of your next true menstrual period may be affected by the hormonal influence of the progesterone pessaries you used 1, 2.