Truth Behind Mifepristone Shedding the Endometrial Lining for Abortion

Medication pregnancy termination is a non-invasive healthcare process. It is undoubtedly safe for women who are pregnant up to 9 weeks of gestation. A combination of medicine helps to end the pregnancy, with an efficacy rate of 95-99% on taking Mifepristone and Misoprostol pills. While most of us are aware that Misoprostol pills dispel the pregnancy portions from the womb through uterine contractions, not many understand the concept behind the Mifepristone medication. Do remember that it is the primary pill in the procedure and plays a vital role.

In this post, we will talk about how Mifepristone abortion pills bring the pregnancy to a stop by shedding the uterine lining.

What is Endometrial Lining in the Uterus?

The endometrial lining is basically a coating in the uterus. Here is the purpose of it and the function to expect:

• For a woman, the release of an egg from the ovaries every month is a part of the expected menstrual cycle. In this time, it thickens so as to prepare for the implantation of an embryo. The fertilized egg attaches to the uterus wall, leading to a pregnancy.
•  But if the egg does not fertilize, the endometrial lining exits the body by shedding. This causes menstrual bleeding.
•  If the endometrial is less than 7mm, then it cannot hold a fertilized egg. In such a case, even after implantation, natural miscarriage may occur.
•  Or, the woman may encounter fertility issues. Now you understand that the thickness of endometrial lining and its presence are required for the pregnancy to stay stable.
•  The uterine lining after all aids in the sustenance of the embryo and offers nourishment to it to let the pregnancy advance further.

Is Endometrial Lining Necessary to Keep a Pregnancy Going?

A group of cells forms the endometrial lining that is based inside the uterus. It is essential for an intrauterine pregnancy and exists in the first trimester. As the pregnancy moves to the second trimester, it is replaced by the placenta. But until then, the uterine lining prevents the detachment of the fertilized egg from the womb. If you menstruate every month, it means the thickened endometrium does not find the egg to implant and sheds to cause a period.

Once you conceive, progesterone hormone increases in the body to keep the endometrial lining intact. The uterine lining has two layers. And these layers are visible in the uterus scan by an ultrasound. There is a functional layer that breaks during menstruation. Then a permanent basal layer also exists. A healthy endometrial lining creates a welcoming environment at the time of ovulation.

So, if you get pregnant, the endometrium does not permit the uterus wall to stick together. Rather, the lining reacts to estrogen and progesterone hormones and gets thicker. After pregnancy, the endometrial develops connections with the placenta. It gives a rich blood supply so that the fetus receives nutrients and other necessities to stay implanted and grow.

Why is a Thick Uterine Lining Important for a Pregnancy?

The uterine wall has a layer of the mucus membrane, and endometrium to let a pregnancy last. The thickness of the second layer of the uterine lining is crucial, which is about 1mm in the womb. But when ovulation begins, new functional layers are formed due to the development of cells. It helps the endometrial lining to get thicker and accept a fertilized egg for implantation. For a pregnancy to survive, the thickness of the layer should be between 8 and 15mm. The thickness of the endometrial varies from one female to another.

How Does Mifepristone Break the Endometrial Lining?

We ran into a detailed explanation about what endometrial lining is and its requirement for a pregnancy to keep going. However, when you want to terminate a pregnancy, the procedure is all about reversing the existence of the uterine wall, so that the implantation cannot stay. Here is where the abortion pill steps in:

• The Mifepristone pill is efficient to undo the chances of being pregnant by shedding the endometrial lining. It does so by creating a lack of progesterone hormone supply.
• As the progesterone hormone is needed to form the cells of the uterine lining, the less amount available results in the breaking of the endometrium.
• The anti-pregnancy hormone action lets the embryo and pregnancy tissues come away from the uterus wall. The pregnancy does not develop anymore. And due to the pregnancy portions remaining in the womb, the expulsion of these is induced by Misoprostol pills.

Final Words

Mifepristone is a potent medication to bring an unexpected pregnancy to end. It sheds the endometrial lining to help with pregnancy termination. By understanding the function of the uterine lining and why it is necessary to get it broken during an abortion, you now know the importance of the anti-progesterone pill.

How does Mifepristone pill work to block Progesterone hormone

Mifepristone is an abortion pill that stops the production of progesterone hormone for the time being. This causes the endometrial lining to break. Once this lining sheds, the attached embryo and pregnancy sections come off from the uterus wall. Thus, the pregnancy also experiences a permanent halt, due to which, the pregnancy cannot continue to advance. You need to take the Mifepristone pill 200 mg orally with water on day 1. It cannot alone expel the pregnancy portions out of the womb.

You have to use the anti-progesterone abortion medication with prostaglandin E1 analog pills known as Misoprostol. You will require 200mcg x 4 pills to be taken 24 to 48 hours after Mifepristone or Mifeprex intake. The anti-progesterone medicine is also available as Generic RU486. If utilising buccally, place the Misoprostol pills in both cheek pouches or under the tongue so they dissolve before intake of the melted contents orally.

If utilising Misoprostol vaginally, put the pills in the vagina and lay down for half an hour. The dissolved medicine will get absorbed in the uterus. Mifepristone may not cause any bleeding or side effects. But after the use of the secondary abortion pills, you can expect heavy bleeding to begin within 2 to 4 hours.

Effects of Mifepristone and Other Abortion Pills

Mifepristone prepares you for an abortion by ending the pregnancy. But the conception parts remain in the uterus itself until labor is induced by medicine to empty the uterus. Misoprostol leads to uterine contractions and helps to remove the products of conception from the womb. It is accompanied by cramps giving rise to pain in the abdomen, waist, back, legs, and elsewhere. The pill also widens the cervix for assisting in the exit of the pregnancy portions from the womb.

Avoid heavy exercise, physical activity, and stress during pregnancy termination. You can manage the temporary side effects with medicine and care. Use large sanitary pads for the bleeding. Do not insert menstrual cups or tampons. Take anti-emetic medicine for nausea and vomiting. Drink lots of water if you have diarrhoea. In case of dizziness, rest well and do not move about much to avoid tripping anywhere. Stay in bed and the comfort of your privacy.

How Does Progesterone Hormone Help a Pregnancy?

Now that you understand that the anti-progesterone medication – Mifepristone is vital in abortion, you must also be curious about the function of the progesterone hormone and how it sustains a pregnancy. We will explain the facts right here:

• Progesterone is a hormone that the placenta, ovaries, and adrenal glands naturally produce during pregnancy. It assists in the implantation of the fertilized egg. So, the embryo stays attached to the uterus wall to keep the pregnancy ongoing in the presence of progesterone.
• You must have heard about progesterone treatments for fertility and medicines for those with problems during pregnancy. But anti-progesterone pills do the opposite. For instance, Mifepristone restricts the hormone so that the uterus wall detaches the embryo from it.
• The hormone progesterone is produced in early pregnancy by the Corpus Luteum. This ovarian follicle keeps the progesterone in existence in the first trimester, after which the level of the hormone starts to reduce as the placenta takes over.
• The pregnancy hormone creates a well-balanced environment for the ovaries and the uterus to relax the muscles and aid the immune system to not combat the DNA. As a result, the pregnancy thrives and transcends to the second trimester.
• The progesterone hormone also causes the luteal phase to start and then thickens the uterus lining to receive the embryo and keep it secured in the endometrial. It thus aids in the growth of the fetus as the pregnancy advances ahead.

But the Mifepristone abortion pill is effective only in the first trimester. It works against progesterone, while Misoprostol creates natural miscarriage-like conditions. This is the reason why medical pregnancy termination is effective only for intrauterine pregnancies that too within 9 weeks of gestation. Thus, you can use the medicines at home by following the advice of your healthcare provider and experience a complete end to your unplanned pregnancy without troubles.

To Conclude

Our body works in ways that science can only explain. And some functions are too complicated to understand, and this is where we step in to decode what keeps the pregnancy going through progesterone hormone, and how the abortion pill, Mifepristone safely terminates it with the assistance of another medication, Misoprostol or Cytolog.

Medical Abortion, Why Women May or May Not Choose It?

Medical abortion is sometimes misunderstood to be unsafe or not that effective to end a pregnancy. However, this is untrue. In fact, more than half of all unplanned pregnancies in the early stages are terminated through abortion pills, not just in the United States, but worldwide. But fewer women may use it due to not being able to understand how the medicine works, or the advantages it has over a surgical pregnancy termination. In this post, we will talk about why women may get hesitant in trusting the medication method, and simultaneously discuss why they also prefer the medicine for unintended pregnancy.

1.      Travel Involved

Most women want a feasible pregnancy termination that can happen without the troubles of traveling for long. So, they find abortion with pills more acceptable. You can use the medicines in a private setting at home. You do not have to travel to a clinic or any pharmacy. You can even obtain the medication by ordering abortion pills online on a prescription. The medicine will arrive at your doorstep within the promised duration. But when it comes to invasive procedures, you need to step out even if the care center is nearby.

2.      The Symptoms and Side Effects

The acceptability of medical abortion is influenced by its symptoms and side effects. You may encounter some abdominal men from uterine contractions caused by Misoprostol medication. It widens the cervix to help dispel the products of conception out of the womb. Heavy vaginal bleeding disperses the pregnancy portions as well. Some of the expected side effects are nausea, diarrhea, headache, tiredness, dizziness, etc. But these are temporary.

3.  Time Taken for Termination

The whole procedure can take anywhere between 24 and 72 hours. This is a natural expectation. The duration for medical abortion depends on how further along you are in pregnancy. If the pregnancy age is lower, then the pregnancy ends sooner, and vice-versa. Thus, try to take the medicine as early as possible in the first trimester to get the quickest outcome. An invasive process may take half an hour or so. Thus, many may want to use this method instead. But it also comes with its own set of cons.

4.      Need for Follow-up

A point of contention is the need for follow-up after the pregnancy termination pill course. You should get it done after 2 weeks of Mifepristone intake. An abdomen ultrasound scan will confirm whether the womb has emptied out completely or not. Taking this precautionary step is important to avoid potential issues from the rare possibility of incomplete abortion. But this is much better than multiple clinic visits in case of surgical abortion. This is why many women choose medical abortion instead.

5.  Bleeding from Abortion Pills

Until the uterus empties, heavy vaginal bleeding follows. The bleeding is a bit lesser in surgical abortion, yet it is not completely absent. The bleeding however reduces after the womb is relieved of all the products of conception. Expect the light bleeding to last for 4 to 8 weeks depending on the gestation age. For some, bleeding is the reason why they may not prefer to end a pregnancy, especially through pills. However, the symptom is just like a natural miscarriage and there is no harm in it. But now everyone is aware of the fact.

6.  Risk of Incomplete Abortion

If the uterus contains any leftover pregnancy portions, then it is an incomplete abortion. The risk of the same is rare as Mifepristone and Misoprostol have a success rate of 97-99%. But in case of such an incident, the pregnancy has to be ended at a clinic, surgically. Women who fear this consequence may be skeptical about medical abortion. However, there is some amount of risk always involved in any medical procedure.

7.  Cannot Use it for Advanced Pregnancy

If the pregnancy is over 9 weeks of gestation, then abortion pills may not work. For such a pregnancy, invasive termination is the only option. Dilation and evacuation or dilation and curettage are the two methods available for pregnancies beyond 9 weeks of age. So, those in the advanced pregnancy stage may not opt for medical abortion due to obvious reasons. However, being careful and noticing early pregnancy signs can help you take the step to terminate early with pills.

To Conclude

Abortion with pills is beneficial for women in early pregnancy. But fewer women may use it due to a lack of awareness about the procedure and how efficiently the pill works.

Studying Cervical Dilation in Surgical and Medical Abortion

The neck of the womb or cervix needs dilation when preparing for an abortion. Now, you can either choose medical abortion or surgical abortion. For a pregnancy less than 9 weeks, abortion pills are a conducive alternative to invasive treatment of unexpected pregnancy. The latter is performed at a clinic by professionals.

It requires check-in to the clinic a few hours in advance so that the cervix can be softened to help with the procedure. Medicines as well as instrument-based dilators are available to widen the cervix. Let us understand the cervical dilation process in medical and surgical pregnancy termination.

Which Cervical Dilation Method Suffices for Medical Abortion?

When using abortion pills, keep in mind that the effective procedure is all about taking the combination of Mifepristone 200mg and Misoprostol 200mcg x 4 pills. Mifepristone is an anti-progesterone that does away with the advancement of pregnancy. It suppresses the pregnancy hormone progesterone to unlock the embryo from the uterus wall by breaking the endometrial lining. But that is the only job done, the rest happens after the administration of Misoprostol pills.

• The cervical dilation and softening occur after taking Misoprostol vaginally. Place a pill one after the other inside the womb and it will gradually relax and widen the cervix.

• The pills will melt over half an hour as you rest and get inside the uterus to cause contractions. Then heavy vaginal bleeding takes place to flush out the pregnancy contents.

• You can also take the medicine buccally by placing the pills under the tongue or both cheek pouches for 30 minutes. The pills dissolve and you intake the remains orally with a sip of water.

• You do not need anesthesia or hospitalization. Instead, take the pills at home by following the prescription and experience a spontaneous emptying of the uterus within a few hours of using Misoprostol medication.

• The benefit here is that you do not require any instrument for cervical dilation as medicines will do that for you. Thus, there is a lower risk of infection and no injury to internal organs. This is why several women prefer to use MTP Kit medicines than surgical abortion for pregnancy termination.

More about Surgical Abortion and Cervical Widening

Here, we will take you through two types of surgical abortion procedures, and how the cervix is widened in the same.

1.  Dilation and Evacuation

You may have to spend the whole day in the clinic. Or remain under observation for a few crucial hours. Nonetheless, cervical preparation is necessary. This method is valid from 14 to 24 weeks of gestation. If you are less than 18 weeks pregnant, then conscious sedation or general anesthesia is provided. If you are over 18 weeks, then general anesthesia is used. The surgeon uses suction equipment and instruments to remove the products of conception.

Widening of the cervix occurs a day before or on the day of the surgery. If it happens on the surgery day, then it may take at least 3 hours to numb and soften the cervix. After reaching the clinic and running through formalities, you will go to the treatment area. Then you will lie down on a bed where supports are provided for the legs. Sedation or anesthesia is given before the procedure begins.

The surgeon will perform a check-up of the vagina and insert a speculum in it. Then he will open and stretch the cervix with the assistance of dilators (rod-like structures). Gentle suction is applied to remove the pregnancy portions into the equipment. Additional instruments may be necessary. The procedure lasts for 10-20 minutes. After the pregnancy termination, you will be monitored for a few hours before discharge.

2.  Dilation and Curettage

D&C or Dilation and Curettage is another method to remove the pregnancy sections from the womb. Here, the surgeon uses a small instrument to open and dilate the cervix. Then, the utilization of a curette (a suction device or sharp instruments) assists to take out the pregnancy tissues, the embryo, the sac, and the remains from the uterus. On the exam table, stirrups will secure your heels so that the surgeon can examine the vagina and put a speculum inside.

Anesthesia is given depending on how further you are into pregnancy and your health. After finding the cervix, he will insert thick rods in the cervix. It will allow for cervical dilation until the part expands sufficiently to continue with the process. The dilator is thinner during insertion but gets thicker with time to open up the cervix better. On removal of the dilation rods, the surgeon will place a sharp-edged instrument (usually spoon-shaped) or a suction device to disengage/collect the uterine tissue and pregnancy sections.

Final Thoughts

For medical abortion, Misoprostol pills are used to dilate the cervix. While in surgical abortion, Misoprostol or dilator rods help with the same. Preparing the cervix for the non-invasive or invasive procedure does consume a few hours. But it eases the pregnancy termination procedure by softening the cervix enough that it is simpler to empty the uterus of all the pregnancy portions.