Why Is My Period Delayed After Abortion? Common Causes and Concerns

Delayed menstruation after an abortion?

Hello Doctor, I underwent a surgical abortion on May 8th (11 weeks pregnant, with fetal heartbeat cessation at over 8 weeks).
As of July 9th, my menstruation has not yet returned.
I had follow-up appointments during the first and second weeks post-surgery, where it was confirmed that the procedure was complete.
In the second and third weeks post-op, I experienced some itching in the vulvar area, but there was no discharge.
Occasionally, I had abdominal pain, which the doctor attributed to uterine contractions.
Eventually, the pain subsided, and everything seemed normal without any itching issues.
However, on June 15th and 16th, I experienced severe abdominal pain, and since my period still hadn't arrived, I returned for a check-up on June 17th.
An ultrasound revealed a follicle, and the doctor stated that my uterus appeared normal, administering a pain relief injection.
On July 3rd, I saw the doctor again, and the endometrial thickness was adequate.
After taking medication to induce menstruation, my period still did not arrive by July 9th, which has caused me significant concern about the possibility of not menstruating.
Currently, I do not have any noticeable abdominal pain.
I would like to ask what could be the reasons for the absence of menstruation (pregnancy test negative).
Could it be possible that there are adhesions in the cervical canal or uterine cavity preventing menstruation? I am eager to return to normalcy and continue trying to conceive, but this situation is quite anxiety-inducing.

s, 30~39 year old female. Ask Date: 2017/07/09

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if your period does not arrive within 3 to 4 days, it could be due to uterine adhesions or other reasons.
If you are still experiencing discomfort, it is advisable to consult a gynecologist.
Wishing you good health.

Reply Date: 2017/07/09

More Info

After an abortion, it is not uncommon for women to experience delays in their menstrual cycle. There are several reasons why your period may be delayed following an abortion, and understanding these can help alleviate some of the anxiety you may be feeling.

1. Hormonal Changes: After an abortion, your body undergoes significant hormonal changes as it adjusts back to its pre-pregnancy state. The levels of hormones such as estrogen and progesterone fluctuate, which can lead to irregularities in your menstrual cycle. It may take some time for your body to stabilize these hormone levels, resulting in a delayed period.

2. Physical Recovery: The physical trauma of an abortion can also affect your menstrual cycle. Your uterus needs time to heal, and during this recovery period, your menstrual cycle may be disrupted. Factors such as uterine contractions, inflammation, and the overall healing process can contribute to a delay in menstruation.

3. Stress and Emotional Factors: The emotional and psychological impact of undergoing an abortion can also play a role in menstrual irregularities. Stress can significantly affect your hormonal balance and menstrual cycle. If you are feeling anxious or stressed about your situation, it could delay your period further.

4. Underlying Medical Conditions: In some cases, underlying medical conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can cause menstrual irregularities. If you have a history of such conditions, it may be worth discussing with your healthcare provider.

5. Cervical or Uterine Adhesions: As you mentioned, there is a possibility of cervical or uterine adhesions (also known as Asherman's syndrome) following an abortion. These adhesions can interfere with the normal shedding of the uterine lining, leading to a delayed period. If your healthcare provider suspects this, they may recommend further evaluation, such as a hysteroscopy, to assess the condition of your uterus.

6. Pregnancy: Although you have already taken a pregnancy test that came back negative, it is essential to ensure that there are no remaining pregnancy hormones in your system. Sometimes, it can take a while for hCG levels to drop to zero after an abortion, which can also affect your menstrual cycle.

Given your situation, it is advisable to continue monitoring your symptoms and maintain open communication with your healthcare provider. If your period does not return within a few weeks, or if you experience any concerning symptoms such as severe pain or unusual discharge, it is crucial to seek medical attention. Your doctor may suggest additional tests or treatments to help restore your menstrual cycle and address any underlying issues.

In the meantime, try to manage stress through relaxation techniques, exercise, and a healthy diet, as these can positively influence your hormonal balance and overall well-being. Remember that recovery can take time, and it is essential to be patient with your body as it heals and adjusts. If you are eager to conceive again, discuss your plans with your healthcare provider to ensure you are in the best possible health for future pregnancies.

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