Irregular Periods: Hormonal Treatment and Its Effects

Irregular menstrual cycle?

Hello, doctor.
A few days ago, my period was late (my last period was on May 20, with an average cycle of 27-30 days), so I went to see a gynecologist.
During the examination, the doctor mentioned that there was something thick inside me (I forgot the medical term for it) and that I needed to thin it out.
The doctor said I was lacking progesterone, and that I did not ovulate in June, possibly due to stress or being underweight.
In any case, the doctor prescribed me hormone medication and an anti-nausea medication because I have an important exam on July 1.
The doctor prescribed a 10-day supply of hormone medication, instructing me to take one pill every night without interruption, so that my period would arrive by July 1.
I started taking the medication on Thursday, June 21.
In the first few days of that week, I experienced light bleeding (the doctor said it was abnormal bleeding, not my period).
However, by the third day of taking the medication, I began to feel signs that my period was about to start, including headaches and some abdominal discomfort, as I always experience headaches before my period, particularly in the temples, so I am quite certain my period is approaching.
After taking the medication, I noticed brown discharge, and today, June 23 (Saturday), I saw blood in the toilet (very similar to menstrual blood).
I currently feel fatigued, which is similar to how I feel when my period is about to start.
I don’t necessarily want my period to come only after my exam on July 1; in fact, I hope it arrives soon so I can get it over with.
However, since the doctor prescribed me a 10-day course of hormone medication, I am unsure whether I should continue taking it.
The doctor advised me not to stop the medication, but my current state leaves me uncertain about what to do.

Nìmíng, 20~29 year old female. Ask Date: 2018/06/23

Dr. Huang Jianzhong reply Obstetrics and Gynecology

My period is late (the last one was on May 20, with an average cycle of 27-30 days), so I went to see a gynecologist.
During the internal examination, the doctor mentioned that my endometrium is very thick and suggested thinning it (I forgot the medical term for that...).
The doctor said I have a deficiency in progesterone, and that I did not ovulate in June, possibly due to high stress or being underweight.
In any case, the doctor prescribed hormone medication and an anti-nausea medication because I have an important exam on July 1.
The doctor prescribed a 10-day course of hormone medication, instructing me to take one pill every night without interruption, so that my period would come by July 1.
I started taking the medication on Thursday, June 21.
In the days leading up to this week, I experienced light bleeding (the doctor said it was abnormal bleeding, not menstruation).
However, by the third day of taking the medication, I began to feel signs that my period was approaching, including headaches and some abdominal discomfort, as I usually experience headaches, especially around the temples, right before my period.
After taking the medication, I noticed brown discharge, and today, June 23 (Saturday), I had blood when I went to the bathroom (very similar to menstrual blood).
I currently feel fatigued, which is typical before my period.
I don't necessarily want my period to come after my exam on July 1; in fact, I hope it arrives soon so I can get it over with.
However, since the doctor prescribed a 10-day course of hormone medication, I'm unsure whether I should continue taking it.
The doctor advised me not to stop the medication, but given my current state, I don't know what to do.

Answer: You should not continue taking the medication.

Reply Date: 2018/06/23

More Info

When it comes to understanding irregular periods and the role of hormonal treatment, it's essential to consider both the benefits and potential drawbacks of such therapies. Hormonal treatments, particularly those involving progesterone or estrogen, can be effective in regulating menstrual cycles, especially in cases where there is a deficiency in these hormones, as indicated by your doctor's assessment of your condition.

In your case, it appears that your doctor has prescribed hormonal medication to address a lack of progesterone, which can lead to irregularities in your menstrual cycle. This is often referred to as luteal phase deficiency, where the body does not produce enough progesterone after ovulation, leading to issues such as delayed menstruation or abnormal bleeding. Stress, significant weight loss, or other lifestyle factors can contribute to this hormonal imbalance.

The medication you are taking is likely designed to help thicken the uterine lining and prepare it for menstruation, which is why your doctor instructed you to take it continuously for ten days. It's common for patients to experience some breakthrough bleeding or spotting when starting hormonal treatments, which can be confusing. This is often referred to as "unscheduled bleeding" and can occur as your body adjusts to the new hormone levels.

Regarding your concern about whether to continue taking the medication, it's crucial to follow your doctor's instructions unless you experience severe side effects or have specific concerns that warrant a discussion. The fact that you are experiencing symptoms consistent with an impending menstrual period—such as cramping and fatigue—suggests that the medication may be working as intended. However, if you feel uncomfortable or uncertain about continuing the treatment, it is advisable to reach out to your healthcare provider for clarification. They can provide guidance based on your specific situation and may adjust your treatment plan if necessary.

In terms of the duration of hormonal treatment, it varies depending on individual circumstances. Some women may need to take hormonal therapy for several cycles to achieve regularity, while others may only require a short course to reset their menstrual cycle. Your doctor will likely monitor your progress and make recommendations based on how your body responds to the treatment.

It's also worth noting that while hormonal treatments can be beneficial, they are not without potential side effects. Common side effects may include mood swings, bloating, breast tenderness, and changes in weight. Long-term use of hormonal therapies can carry risks, such as an increased risk of certain cancers, particularly if there is a family history or other risk factors present. Therefore, it's essential to have open discussions with your healthcare provider about the risks and benefits of ongoing treatment.

In summary, hormonal treatments can be an effective way to manage irregular periods, especially when there is a deficiency in hormones like progesterone. It's important to follow your doctor's guidance, monitor your body's response to the medication, and maintain open communication with your healthcare provider. If you have any concerns or experience significant changes in your symptoms, don't hesitate to seek further medical advice. Your health and well-being should always be the priority, and your doctor is there to help you navigate these challenges.

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