Delayed Menstruation and Its Causes: A Patient's Journey

Menstrual delay, took medication to regulate menstruation?

Hello Doctor, my previous menstrual periods were on July 1, August 5, and September 2.
Each time, I experienced severe pain, to the point of vomiting for some relief.
On the last day of my period, I also had a headache.
This month, my period is already 13 days late.
On October 11, I visited a nearby gynecology clinic and took a pregnancy test, which was negative.
The last time I had intercourse with my boyfriend was around October 4.
I have taken menstrual induction medication on October 11, 12, and 13, but my period has not yet arrived.
Since around September 30, I have been experiencing some dull pain in my lower abdomen, similar to menstrual cramps, and I also feel dizzy and anemic when I get up (which I used to experience before my period).
However, my period still hasn’t come.
After taking the induction medication, the symptoms have become more frequent.
The gynecologist performed an internal examination and prescribed suppositories.
The doctor mentioned that if my period does not come within 5-7 days after taking the medication, I need to return for a follow-up.
The doctor also said that if I continue to gain weight, my period may not come, which worries me (the doctor was in a hurry to see the next patient, so I couldn't ask more questions).
I have indeed gained 7-8 kilograms since last September (I am 150 cm tall and my weight is approaching 60 kg), and I only eat three meals a day.
I apologize for the lengthy explanation, but here are my questions: 1.
Why did the doctor say that if I continue to gain weight, my period may not come? 2.
If the pregnancy test on October 11 was negative, does that mean I am definitely not pregnant? 3.
I have experienced a year without menstruation a few years ago and have also gone two to three months without a period.
The last time was five months ago when I went 40 days without a period.
I am worried whether this time it is irregular menstruation, pregnancy, or some other health issue.
Thank you, Doctor, for your patience in reading this, and I appreciate your help.

Yu, 20~29 year old female. Ask Date: 2017/10/16

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, individuals who are overweight or obese are more likely to experience menstrual irregularities.
The chances of detecting pregnancy on October 11th are low.
If your menstrual cycle is irregular, it is advisable to visit a gynecologist.
Wishing you good health.

Reply Date: 2017/10/16

More Info

Dear Patient,
Thank you for sharing your concerns regarding your delayed menstruation and the associated symptoms you are experiencing. It’s understandable to feel anxious when faced with such changes in your menstrual cycle, especially when they are accompanied by significant pain and discomfort. Let’s address your questions and provide some context regarding your situation.

1. Why did the doctor say that if you continue to gain weight, your menstruation may not come?
Weight gain can significantly impact menstrual cycles due to hormonal changes. Increased body fat can lead to higher levels of estrogen, which can disrupt the normal hormonal balance necessary for ovulation and menstruation. This condition is often referred to as anovulation, where the ovaries do not release an egg, leading to irregular or missed periods. Additionally, obesity can be associated with conditions such as polycystic ovary syndrome (PCOS), which is characterized by irregular menstrual cycles, weight gain, and other metabolic issues. Therefore, maintaining a healthy weight is often emphasized in discussions about menstrual health.

2. If the pregnancy test on 10/11 was negative, does that mean you are definitely not pregnant?
While a negative pregnancy test is a strong indicator that you are not pregnant, it is important to consider the timing of the test. If the test was taken too early, it might not detect a pregnancy even if one exists. Generally, it is recommended to wait at least a week after a missed period for the most accurate results. Since your last sexual encounter was on 10/4 and you tested on 10/11, it is possible that if conception occurred, it might not have been detectable yet. If your period does not arrive after taking the medication, it would be prudent to follow up with your healthcare provider for further evaluation.

3. You mentioned having periods of amenorrhea (absence of menstruation) in the past. What could be causing this?
Amenorrhea can be caused by various factors, including hormonal imbalances, stress, significant weight changes, excessive exercise, or underlying medical conditions such as thyroid disorders or PCOS. Given your history of irregular cycles and the recent weight gain, it is essential to have a thorough evaluation by a healthcare provider. They may recommend blood tests to check hormone levels, thyroid function, and possibly an ultrasound to assess your reproductive organs.

In addition to these points, the symptoms you describe, such as abdominal pain and dizziness, warrant attention. The pain you experience could be related to your menstrual cycle or other conditions such as endometriosis or ovarian cysts. The dizziness and feelings of anemia may suggest that your body is not handling the hormonal fluctuations well, or it could be related to dietary factors, especially if you are not eating adequately.

I encourage you to maintain open communication with your healthcare provider. If you feel rushed during appointments, consider preparing a list of questions or concerns to ensure you address everything important to you. If your symptoms persist or worsen, or if your period does not return after the medication, please seek a follow-up appointment as advised by your doctor.

Lastly, remember that you are not alone in this journey. Many women experience similar issues, and there are effective treatments available. It’s crucial to advocate for your health and seek the support you need, both physically and emotionally.

Take care, and I wish you the best in your journey toward understanding and managing your menstrual health.

Sincerely,
Doctor Q&A Teams

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