Menstrual Irregularities: Causes and Concerns

Menstrual irregularities

Following the article #128984, I would like to ask the doctor about the reasons for my situation.
I had sexual intercourse on 9/22 and 9/29, using condoms throughout, and they were checked for any breaks.
My period was expected on 9/26, but it has not arrived yet.
In between, I had a small amount of brown discharge.
I took dermatological medication and visited a gynecologist on 10/5, where I had an ultrasound and a urine test, both showing no pregnancy.
The doctor prescribed menstrual induction medication on 10/2, and I also took a home pregnancy test on 10/3, which was negative.
My last menstrual period was from 8/24 to 8/30, the one before that was from 7/27 to 8/1, and the one before that was from 6/23 to 6/30.
I finished the menstrual induction medication on 10/8, but my period still hasn’t come.
On 10/13, I experienced diarrhea, which seemed like gastroenteritis, and on 10/19, after having a teppanyaki steak for dinner, I had constipation and felt nauseous.
On 10/17, I took a pregnancy test again, which showed one line, and now my period is 23 days late.
Could you please explain what this situation might be? It feels a bit urgent, and I sometimes experience shortness of breath.
The last time you mentioned it could be due to endocrine imbalance, and I would like to ask you again.

Youyouyou, 20~29 year old female. Ask Date: 2017/10/19

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On September 22 and September 29, I had sexual intercourse with a condom, and it was checked to ensure it did not break.
My period was originally expected on September 26, but it has not arrived yet.
In between, I had a small amount of brown discharge.
I took dermatological medication and visited a gynecologist on October 5, where I had an ultrasound and a urine test, both of which showed no pregnancy.
The doctor prescribed medication to induce menstruation on October 2, and I also took a home pregnancy test on October 3, which was negative.
My last menstrual period was from August 24 to August 30, the one before that was from July 27 to August 1, and the one before that was from June 23 to June 30.
I finished the medication to induce menstruation on October 8, and I still have not gotten my period.
On October 13, I experienced diarrhea, which was somewhat like gastroenteritis, and on October 19, after having a teppanyaki steak for dinner, I had a bowel movement that was constipated and felt nauseous.
On October 17 (21 days late), I took a pregnancy test again, which showed one line.
Now I am 23 days late.
Doctor, what could this situation be? It feels a bit urgent.
During this period, I sometimes experience shortness of breath.
Last time, you mentioned it could be hormonal imbalance.
I would like to ask you again.

Answer: The last menstrual period was from August 24 to August 30.
A pregnancy test on October 17 showed one line.
It is likely still a hormonal imbalance.
An ultrasound and blood tests to check hormone levels are needed for confirmation.

Reply Date: 2017/10/19

More Info

Menstrual irregularities can be a source of concern for many women, and understanding the underlying causes is crucial for addressing any potential health issues. Based on your description, it seems you have experienced a significant delay in your menstrual cycle, along with some unusual symptoms such as brown discharge, gastrointestinal issues, and feelings of nausea.
Firstly, it’s important to note that menstrual cycles can be influenced by a variety of factors, including hormonal imbalances, stress, lifestyle changes, and underlying medical conditions. In your case, you mentioned that you had sexual intercourse on September 22 and 29, with protection, and that you have taken pregnancy tests that returned negative results. This is reassuring, as it suggests that pregnancy is unlikely to be the cause of your missed period.

The fact that your last menstrual period was from August 24 to August 30, and you were expecting your next period around September 26, indicates that you are now experiencing a delay of over three weeks. Hormonal imbalances, particularly involving estrogen and progesterone, can lead to irregularities in the menstrual cycle. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, and other endocrine issues can also contribute to menstrual irregularities.

You mentioned that you have been taking medication for skin issues and that you visited a gynecologist who performed an ultrasound and urine test, both of which did not indicate pregnancy. The gynecologist prescribed medication to induce menstruation, which you took on October 2 and 3. If your period has still not arrived, it may be worth considering other factors that could be affecting your cycle.

Stress is another significant factor that can disrupt hormonal balance and lead to missed periods. If you have been experiencing increased stress or anxiety, this could be a contributing factor. Additionally, significant changes in weight, exercise habits, or diet can also impact menstrual regularity.

The gastrointestinal symptoms you described, including diarrhea and constipation, could be related to a viral infection or dietary changes, but they may also be linked to stress or hormonal fluctuations. It's not uncommon for women to experience gastrointestinal symptoms during hormonal changes, especially around the time of their expected period.

Given your situation, it is advisable to continue monitoring your symptoms and maintain open communication with your healthcare provider. If your period does not resume soon or if you experience additional concerning symptoms, such as severe abdominal pain, heavy bleeding, or persistent nausea, it would be prudent to seek further evaluation. Your healthcare provider may recommend additional tests, such as blood tests to check hormone levels, thyroid function, or other potential underlying conditions.

In summary, menstrual irregularities can arise from a variety of causes, including hormonal imbalances, stress, and lifestyle factors. Since you have already taken steps to investigate the issue with your healthcare provider, it is essential to continue following their guidance and to report any new or worsening symptoms. Your health and well-being are paramount, and addressing these concerns with a medical professional will help you find the appropriate solutions.

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