Retrograde Menstruation

Retrograde menstruation is when your period flows upward through your fallopian tubes and into your pelvis instead of out your vagina. It’s a normal part of menstruation, but can lead to conditions like endometriosis.


What is retrograde menstruation?

Retrograde menstruation is when blood from your period flows backward into your abdomen instead of out your vagina. In a typical menstrual period, your uterine lining (which is a mix of blood and tissue) flows downward and out your vagina. With retrograde menstruation, the blood flows up through your fallopian tubes and into your abdomen. Retrograde menstruation is common and doesn’t typically cause problems.

Healthcare providers believe people with retrograde menstruation may be at higher risk for developing endometriosis. Endometriosis is a common condition where your uterine lining grows outside your uterus. When you have retrograde menstruation, it’s possible that cells from your endometrium (the lining of your uterus) grow on your abdominal or pelvic organs.

Who is likely to get retrograde menstruation?

Any person who menstruates can have retrograde menstruation. It’s a normal part of the menstrual process and usually not a cause for worry. It becomes a problem when it leads to painful symptoms or a condition like endometriosis.


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Do you bleed with retrograde menstruation?

Yes. People with retrograde menstruation still bleed from their vagina, but some of the bleeding flows in the wrong direction. Instead of coming out your vagina, the blood flows upward through your fallopian tubes and into your abdominal and pelvic cavity. The cells can then grow superficially on the peritoneum (the lining of your abdominal wall that covers your stomach, spleen, intestines and other abdominal organs), or deeper into the abdominal or pelvic organs.

Symptoms and Causes

What are the symptoms of retrograde menstruation?

Most people don’t have symptoms of retrograde menstruation. In those that do, the most common symptom is a painful period. Others may report having a lighter period. This is because the blood is flowing back into their abdomen instead of out their vagina into their pad, tampon or menstrual cup.

Despite sounding alarming, it’s normal to experience some retrograde menstruation.


What causes retrograde menstruation?

Researchers aren’t exactly sure what causes retrograde menstruation, but many believe it may lead to endometriosis. Factors like having a small cervical opening or genetics may also play a role.

Does retrograde menstruation cause endometriosis?

Several studies show a correlation between retrograde menstruation and developing endometriosis. It’s possible that if you have retrograde menstruation, endometrial cells (cells in your uterine lining) make their way through your fallopian tubes and into your pelvis. If your body doesn’t clear the cells, they could build up on the pelvic organs, causing endometriosis.


Diagnosis and Tests

How is retrograde menstruation diagnosed?

Your healthcare provider may diagnose retrograde menstruation during an examination of your pelvic organs such as during laparoscopy. This type of procedure allows your provider to see the inside of your abdomen, where they may discover blood. Typically, diagnosing retrograde menstruation occurs while they’re evaluating another condition. For example, you may visit your provider for symptoms of endometriosis or pelvic pain and they discover blood in your abdomen or pelvis.

Management and Treatment

What is the treatment for retrograde menstruation?

Retrograde menstruation doesn’t require treatment unless it’s causing other symptoms or conditions. Some healthcare providers prescribe hormones that reduce menstrual bleeding. This can reduce how much blood flows backwards into your abdomen.

Hysterectomy (surgery to remove your uterus) is one way to eliminate retrograde menstruation, but this surgery is usually only performed if medically necessary.


How can I reduce my risk of retrograde menstruation?

Retrograde menstruation is a common part of the menstrual cycle that usually doesn’t cause problems. However, hormone medications that make your period lighter can help prevent retrograde menstruation.

Outlook / Prognosis

What are complications of retrograde menstruation?

Retrograde menstruation itself isn’t usually a concern. However, it may be concerning if it causes painful symptoms or leads to medical conditions affecting your reproductive system. For example, retrograde menstruation can lead to painful conditions like endometriosis.

Living With

When should I contact my healthcare provider?

Contact a healthcare provider if you have any concerns about your menstrual period. This could include:

  • Changes in how much you bleed.
  • New symptoms such as painful periods or other pelvic pain.
  • Dizziness.
  • Vomiting.

Your healthcare provider can evaluate your symptoms and examine you to make sure your concerns aren’t a cause for worry.

Additional Common Questions

Why does my period feel like it’s stuck?

If your period feels stuck or doesn’t seem to be coming out, it could be due to hormonal changes or from some type of obstruction. If your period feels unusual or different than normal, it’s best to contact a gynecologist for an evaluation.

A note from Cleveland Clinic

Retrograde menstruation is a normal part of menstrual bleeding and usually not a cause for worry. Contact a healthcare provider if you experience severe pain during your period. Retrograde menstruation can lead to more complicated conditions like endometriosis, which require treatment.

Medically Reviewed

Last reviewed on 11/10/2022.

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