PCOS Medication Discontinuation: Delayed Period Concerns and Next Steps

After six months of medication for polycystic ovary syndrome (PCOS), menstruation has not resumed after stopping the medication?

Hello, doctor.
It has been six months since I was diagnosed with polycystic ovary syndrome (PCOS).
During this time, I have been taking birth control pills to regulate my menstrual cycle, and my periods were regular while on the medication.
However, during my recent follow-up ultrasound, it was found that the follicles next to my ovaries had disappeared.
Therefore, my primary physician suggested that I stop the medication and observe whether my menstrual cycle will normalize.

However, after stopping the medication, my period has been delayed by about 10 days.
My next follow-up appointment is at the end of June.
I would like to know if I should go to the clinic for a menstrual induction injection or if I should schedule an earlier appointment, or if I should continue to observe and discuss this with my physician at my next visit.
I am concerned about the possibility of immature follicles remaining in my body.
Additionally, I have gained some weight due to frequent eating out, so should I focus on weight management and observe whether my period comes next month?

Ann, 20~29 year old female. Ask Date: 2016/05/17

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, you can first visit the obstetrics and gynecology department.
You can take menstrual induction medication, and once your period arrives, you can start taking ovulation medication to regulate your cycle.
Wishing you good health.

Reply Date: 2016/05/17

More Info

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder that affects many women of reproductive age. It can lead to a variety of symptoms, including irregular menstrual cycles, weight gain, and fertility issues. In your case, you have been on hormonal contraceptives to regulate your menstrual cycle, and after discontinuing the medication, you are experiencing a delay in your period. This situation raises several important considerations regarding your health and the management of PCOS.

Firstly, it is not uncommon for women with PCOS to experience irregular menstrual cycles, especially after stopping hormonal contraceptives. The body may take some time to readjust to its natural hormonal rhythms, and this can lead to delays in menstruation. The fact that your periods were regular while on the pill indicates that the medication was effectively managing your symptoms. However, once you stop taking it, your body may need time to recalibrate, which can result in a delayed period.

In your case, since your period is already 10 days late, it is understandable that you are concerned. While it is generally advisable to wait until your next scheduled appointment to discuss any changes with your healthcare provider, there are a few factors to consider. If you are experiencing any additional symptoms, such as severe abdominal pain, unusual discharge, or signs of pregnancy, it would be prudent to contact your doctor sooner. Additionally, if you have a history of developing cysts or other complications related to PCOS, it may be wise to seek medical advice sooner rather than later.

Regarding your concern about immature follicles remaining in your ovaries, it is important to note that the presence of follicles does not necessarily indicate a problem. Many women with PCOS have multiple follicles that may not mature into eggs during each cycle. This is part of the condition and does not typically require intervention unless it leads to significant symptoms or complications. Monitoring through ultrasound can help assess the situation, and your healthcare provider can guide you on the best course of action based on your individual circumstances.

As for your weight, managing your weight is an important aspect of PCOS treatment. Excess weight can exacerbate insulin resistance, which is often associated with PCOS and can further complicate menstrual irregularities. If you have gained weight due to dietary changes, such as eating out frequently, it may be beneficial to focus on a balanced diet and regular physical activity. This can help improve your overall health and may also positively impact your menstrual cycle.

In summary, while it is generally advisable to wait until your next appointment to discuss your delayed period, you should not hesitate to reach out to your healthcare provider if you have any concerning symptoms or if your anxiety about the situation increases. It is also important to focus on maintaining a healthy lifestyle, including weight management, as this can play a significant role in managing PCOS symptoms. Your healthcare provider can offer personalized advice and may suggest monitoring your cycle for a few more weeks before considering any medical interventions, such as inducing menstruation.

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