Post-Induction Concerns: Irregular Periods and Ovarian Cysts Explained

Issues After Induction of Labor

Hello Dr.
Huang! I would like to ask you about my situation.
After I had a miscarriage at 15 weeks due to premature rupture of membranes in June, my menstrual cycle has been irregular.
My first period in July was 24 days, then 32 days in September, and 24 days in October.
Now in November, I am over two weeks late.
Since I am working in Vietnam, I went to the Singapore International Hospital for an examination on November 21.
During the ultrasound, the technician mentioned that there are two cysts on my right ovary measuring 24x18 mm and 20x15 mm, and my endometrial thickness is 6 mm.
I also had blood tests done, but when I returned to the consultation room, the doctor had to perform an emergency surgery, so I couldn't ask about the cysts.
After returning home, I researched the possible causes online and found that some cysts may resolve with menstruation, while others may require surgical removal.
This information made me very anxious because I really want to conceive again soon!
I would like to know if the cysts could be related to my diet.
Since the surgery, I have been drinking black bean water and soy milk daily, and I am also taking inositol, chaste tree berry, arginine, CoQ10, and vitamin D3.
Could these supplements be contributing to my condition? Additionally, could the absence of my period be influenced by the cysts or the surgery I had in June? Is an endometrial thickness of 6 mm considered too thin? Given my age, I am really worried about infertility.
I would appreciate it if you could respond to my questions.
Thank you!

EE, 30~39 year old female. Ask Date: 2017/11/23

Dr. Huang Jianzhong reply Obstetrics and Gynecology

This June, after inducing labor due to premature rupture of membranes at 15 weeks, my menstrual cycle has been irregular.
My first period in July had a cycle of 24 days in August, 32 days in September, and 24 days in October.
Now, in November, I am over two weeks late.
Since I am working in Vietnam, I went to the Singapore International Hospital for a check-up on November 21.
During the ultrasound, the technician noted two cysts on my right ovary measuring 24x18 mm and 20x15 mm, and my endometrial thickness was 6 mm.
Additionally, I had blood tests, but when I returned to the consultation room, the doctor had to perform an emergency surgery, so I couldn't inquire about the cysts.
After returning, I researched online and found that some cysts may resolve with menstruation, while others may require surgical removal.
This made me feel very discouraged because I really want to conceive again soon!
So, I would like to ask:
1.
Could the cysts be caused by my diet?
Answer: No.

2.
Since the surgery, I have been drinking black bean water and soy milk daily, and I am also taking inositol, chaste tree berry, arginine, CoQ10, and vitamin D3.
Could these supplements be related?
Answer: It is unlikely.

3.
Could the absence of my period be influenced by the cysts?
Answer: It is possible.

4.
Or could it be due to the effects of the surgery in June?
Answer: It's hard to say.

5.
Is an endometrial thickness of 6 mm considered too thin?
Answer: An endometrial thickness of 6 mm is not too thin.

Reply Date: 2017/11/23

More Info

I'm sorry to hear about your recent experiences and the challenges you're facing with your menstrual cycle and ovarian cysts. Let's break down your concerns regarding irregular periods, ovarian cysts, and their potential implications for your reproductive health.

Irregular Periods Post-Induction
After an induction or miscarriage, it is not uncommon for menstrual cycles to become irregular. The hormonal fluctuations that occur during and after pregnancy can lead to changes in your cycle length and flow. It can take several months for your body to return to its pre-pregnancy hormonal balance. The variations you've noted in your cycle lengths (24 days, 32 days, etc.) are within a range that can be expected during this adjustment period. However, if your period has been absent for over two weeks, it may be worth further investigation.

Ovarian Cysts
Regarding the ovarian cysts you mentioned, they are fluid-filled sacs that can develop on the ovaries. The sizes you reported (24x18 mm and 20x15 mm) indicate that these are relatively small cysts. Many women experience ovarian cysts at some point, and they often resolve on their own without treatment. However, if they cause pain or other symptoms, or if there are concerns about their nature (e.g., whether they might be benign or malignant), further evaluation may be necessary.

Cysts can sometimes be influenced by hormonal changes, and while diet can play a role in overall health, it is less likely that your specific dietary choices (like consuming black bean water, soy milk, or supplements) are directly causing these cysts. However, maintaining a balanced diet and healthy lifestyle can support your overall reproductive health.

Impact on Menstrual Cycle
The presence of ovarian cysts can affect your menstrual cycle. Some cysts can produce hormones that may disrupt your cycle, leading to irregular periods. Additionally, if the cysts are related to conditions like polycystic ovary syndrome (PCOS), this could further complicate your menstrual regularity.

Uterine Lining Thickness
Regarding your uterine lining measurement of 6 mm, this is considered on the thinner side, especially if you are in the luteal phase of your cycle (the phase after ovulation). A thicker endometrial lining is generally more conducive to implantation if you are trying to conceive. However, the thickness can vary depending on the phase of your cycle, and a 6 mm lining may still be adequate for some women, particularly if you are not currently trying to conceive.

Concerns About Fertility
Given your age and the recent changes in your menstrual cycle and ovarian health, it is understandable to have concerns about fertility. If you are considering trying to conceive again, it may be beneficial to consult with a fertility specialist. They can provide a comprehensive evaluation, including hormone testing and possibly imaging studies, to assess your ovarian reserve and overall reproductive health.

Conclusion
In summary, while irregular periods and ovarian cysts can be concerning, they are not uncommon after a pregnancy loss. It is essential to monitor your symptoms and maintain open communication with your healthcare provider. If you experience significant pain, changes in your symptoms, or if your period does not return, further evaluation may be warranted. Additionally, consider discussing your dietary habits and supplement use with your doctor to ensure they align with your health goals. Remember, seeking support from healthcare professionals can provide you with the guidance and reassurance you need during this time.

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