What is implantation?

Pregnancy brings a myriad of transitions in the body of a woman. From the start of the first trimester until the fetus's delivery, the mother's body sustains everything from pain, food cravings, swelling of legs, and morning sickness. Implantation cramping is also an early sign of pregnancy that is associated with slight abdominal pain. It is crucial to grasp the concept of implantation for a clear picture. 

After fertilization of the ovum and the sperm, an embryo is produced that grows into a baby during the nine months of gestation period. The fetus anchors itself on the walls of the uterus, known as implantation. Implantation is defined as the stage of pregnancy at which the embryo adheres to the uterus wall. It invades the epithelial lining of the uterus and reaches the maternal circulation to derive nutrition for the growing baby. Successful implantation requires a receptive environment in the womb and a competent blastocyst. The implantation occurs during the 16th to 22nd days of the menstrual cycle, commonly known as the window of implantation. If implantation occurs before the window or beyond it, the risk of spontaneous abortion proliferates. The symptoms of early pregnancy differ from woman to woman. While some might feel the morning sickness, implantation crampings have been reported in some during the early weeks of pregnancy. The implantation cramps are just like menstrual cramps, which is observed when the blastocyst implants in the uterine lining. Implantation cramping comes about 10 to 11 days after you have conceived successfully. 

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Why does implantation cramping occur?

The reasons behind implantation cramping

 There is less known evidence of the appropriate reasons behind the experience of implantation crampings a few weeks after conception. The significant reasons cited are the uterus' physical attributes and the effect of progesterone and estrogen on it during the luteal phase (the window of implantation). The contractile property of the uterus provides movement to the male and female gametes. During implantation, it helps the embryo to get attached to the wall of the uterus. In many women, this contraction is painless, but some experience abdominal pain or cramps, just like in periods. This cramping is one of the major contributory reasons that pregnant ladies confuse early pregnancy signs with the onset of their menstrual cycle. The construction of the uterus is highly regulated by female reproductive hormones like progesterone and estrogen. The squeezing or peristaltic movement of the uterus helps the embryo to interact with the surface of the womb to get attached and develop a placenta for further growth. The spasms of the uterus hold significant importance in assisted reproductive techniques as they help in the successful implantation of the embryo. In such cases, inadequate contraction of the uterus can lead to ectopic pregnancy, miscarriages, and endometriosis.

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Implantation cramps symptoms

Symptoms of implantation cramps

All pregnant women do not experience implantation cramps, but those with cramps may be mild to moderate pain. The familiar sensations during implantation cramping are stinging, jerking, or tingling feelings in the lower abdomen. These sensations help to decipher implantation cramps from monthly menstrual cramps. Another common symptom followed by cramping is bleeding during implantation. Vaginal bleeding during the first trimester of pregnancy is alarming, but studies have suggested that it is quite prevalent in 7 to 24% of the pregnant population. Light bleeding or spotting episodes are widespread in early pregnancy, but when the bleeding is heavy, and for an extended duration, it indicates adverse outcomes. Heavy bleeding may be due to abortion, ectopic pregnancy, infection, and polyps.

See: Ovulation Bleeding Causes & Pregnancy

Early pregnancy signs

Other signs of early pregnancy

There is a set of classic symptoms that are indicative of the pregnant condition of a woman. The familiar symptoms that can draw your attention to undergo a pregnancy test are as follows: 

●       Skipped menstrual cycle: The missed periods for more than a week is a symptom of pregnancy. But, it can be deceiving if your menstrual cycle is irregular

●       Nausea and vomiting: In the initial months of the first trimester, morning sickness knocks at your doorsteps. While some may feel nausea only in the early days, some may suffer from the condition throughout their gestation period. 

●       Tender breasts: Sensitive breasts are a common indication of your pregnancy. The hormonal fluctuations result in a tender and sore mammary glands that will reduce as the pregnancy advances. 

●       Fatigue and drowsiness: As the pregnancy sets in, the level of the female hormone called progesterone upswings. It leads to sleepiness and fatigue after small chores. 

●       Bloating: Hormonal fluctuations can lead to bloating during early pregnancy. It resembles the bloating you experience before your menses.

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Implantation cramping in early pregnancy complications

Complications associated with implantation cramping in early pregnancy

Implantation cramps are considered an early symptom of pregnancy, but if the spasms are intense and followed by excessive bleeding, it signifies pregnancy complications. Ectopic pregnancy, incomplete abortion, the early loss of a pregnancy can also lead to cramps. When a woman complains of cramps having 1500 to 2000 IU/L human chorionic gonadotropin levels, the ultrasound reveals a gestational sac. If the cramps are without the sac, it indicates ectopic pregnancy. A woman who has suffered from incomplete abortion is subjected to surgical evacuation, while cramps due to early pregnancy loss are relived by misoprostol. 

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How do implantation cramps feel?

How to recognize implantation cramps

Not everybody has cramps during implantation. And for the ones that do, the cramps may be mild or moderate. Some women describe the feeling as pulling, pricking, or just a tingling sensation. This may help distinguish it from a menstrual cramp. It's unusual to have extreme cramping pain during implantation, so anybody who encounters painful cramping between intervals should be evaluated by a health care provider. Implantation tends to occur 6 to 12 days following childbirth when pregnancy occurs. This is about exactly the exact same time that somebody would usually expect time to get started. Once an egg has been fertilized, the body undergoes changes in the uterus lining to get and protect the egg. Some light bleeding or spotting can accompany implantation cramping. This light bleeding is called implantation bleeding and is lighter than a normal period.

Signs of early pregnancy may include headaches, extreme fatigue, and increased body temperature. Implantation cramping or bleeding could be an early indication of pregnancy. It's easy to mistake period a mild period for symptoms of implantation. Due to the similar symptoms between menstruation and implantation, it is helpful to understand the other early signs of pregnancy.


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Implantation cramping vs menstrual cramps difference

Confusion of implantation cramping with menstrual cramps

Pregnant women are likely to confuse implantation cramps with period cramps. And when it is accompanied by spotting or bleeding, they ignore other early signs of pregnancy. Women in the reproductive years should keep in mind that cramps after you have missed your periods can be an initial symptom of conception. Although there are other factors for endometriosis like periods, emotional distress, and infections, one of them can be pregnancy. So if you are experiencing cramps or pain in the lower abdomen with missed periods, make sure to take a confirmatory pregnancy test or visit your physician for confirmation. 

It's not unusual for cramping also to accompany implantation. Implantation cramping is usually very mild compared to menstrual cramps and some women describe a light pulling, tingling, or pricking sensation. Implantation cramps are generally felt in the lower abdomen or back and only a few women experience them on a single side of the body. Some women may also feel woozy and tired during implantation, experience breast tenderness, or a small elevation in body temperature (by about 1 degree).

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Consult with a doctor

See a doctor

Anyone who knows they're pregnant and is experiencing heavy bleeding or cramping should talk to a physician. These signs may indicate a problem with the pregnancy. If a person believes they are pregnant, it's a great idea to take a home pregnancy test. A good time to do this is 1 to 2 weeks after discovering the early signs of pregnancy. Pregnancy tests are available to purchase in supermarkets, health shops, and online. If a fertilized egg has implanted itself into the uterus wall, then the body will have begun to form the placenta. In this circumstance, the pregnancy hormone, human chorionic gonadotropin (hCG), starts to rise. Approximately 2 weeks after implantation, hCG levels will be high enough to get a pregnancy test to show a positive result. Once the pregnancy test is confirmed, the next thing to do is to make an appointment with a physician. The health care provider can confirm whether the house test is accurate.

See: Prevent Menstrual Migraines & Hormonal Headaches

Summary

Implantation cramping is usually not a reason to worry as some women experience it as initial pregnancy signs. The abdominal pain diminishes with time, but if it persists and gets severe medical consultation must be sought. 

See: Pregnancy Diet & Nutrition

References

1.      Kim, S. M., & Kim, J. S. (2017). A review of mechanisms of implantation. Development & reproduction, 21(4), 351.

2.      Bulletti, C., & De Ziegler, D. (2005). Uterine contractility and embryo implantation. Current Opinion in Obstetrics and Gynecology, 17(3), 265-276.

3.      Hasan, R., Baird, D. D., Herring, A. H., Olshan, A. F., Funk, M. L. J., & Hartmann, K. E. (2010). Patterns and predictors of vaginal bleeding in the first trimester of pregnancy. Annals of epidemiology, 20(7), 524-531.

4.      https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/symptoms-of-pregnancy/art-20043853

5.      Aggarwal, K. (2020). Vaginal Bleeding in Early Pregnancy. In Labour Room Emergencies (pp. 155-161). Springer, Singapore.

6.      Lemaire, G. S. (2004). More than just menstrual cramps: symptoms and uncertainty among women with endometriosis. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 33(1), 71-79.

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