###Human: I have early periods with heavy clots, cramping and back pain. Are these signs of miscarriage? ###Assistant: Hello. First, to confirm a pregnancy, you should perform a pregnancy test two weeks after having sexual intercourse. So perform a urinary pregnancy test or b-HCG (human chorionic gonadotropin) test to exclude or to confirm a pregnancy. And after that perform an ultrasound to evaluate the uterine cavity. On the other hand, maybe your menses have come earlier and has a different pattern compared with other menstrual bleeding. As you use the patch for one year there are low chance of pregnancy always, if you have used it correctly.