Menstrual Irregularities: Causes and Treatment Options

Menstrual regulation medication for menstrual issues?

According to the previous menstrual history of the girlfriend, her last period was from May 9 to May 14, the one before that was from April 3 to April 8, and the one before that was from February 18 to February 23.
We had sexual intercourse on June 9, June 22, and June 23, using condoms throughout, and there were no breakages upon inspection.
On June 28 (10 days late), we visited a gynecologist who performed an ultrasound and a pregnancy test, both of which indicated no pregnancy.
On July 2 (14 days late), I also conducted a home pregnancy test using two different brands, and both were negative.
During this period, she experienced breast tenderness and increased discharge.
We used a menstrual tracking app, which indicated that her period was expected between June 18 and June 23.
Now, on July 9 (21 days late), her period has still not arrived.

I would like to ask the doctor what this situation might indicate.
Is there a possibility of pregnancy, or could there be other symptoms?
Response: On June 28, the ultrasound and pregnancy tests indicated no pregnancy after a 10-day delay.
On July 2, after a 14-day delay, the tests were also negative.
This suggests that her menstrual cycle is irregular rather than indicating pregnancy.

Additionally, the gynecologist prescribed a three-day course of medication to induce menstruation, which was to be taken twice daily, but my girlfriend only took it in the morning, effectively taking half the prescribed dose.
The doctor mentioned that menstruation would occur 2-3 days after completing the medication.

(1) Will taking only half the dose prevent the desired effect?
(2) What could be the situation?
(3) Should we return to see the doctor?
(4) What recommendations are there for regulating her menstrual cycle?

fa wen, 10~19 year old female. Ask Date: 2018/07/10

Dr. Huang Jianzhong reply Obstetrics and Gynecology

(1) Yes, taking only half the prescribed dosage may not achieve the desired effect.

(2) The situation may lead to an incomplete response to the medication, which could delay the onset of menstruation.

(3) It is advisable to consult a doctor again.

(4) For regulating menstruation, it is recommended to take the medication as prescribed, both in the morning and evening.

Reply Date: 2018/07/10

More Info

Menstrual irregularities can be a source of concern for many women, and understanding the underlying causes and treatment options is essential for effective management. Based on the information provided, your girlfriend has experienced a delay in her menstrual cycle, which has raised questions about potential pregnancy and the effectiveness of the prescribed medication.

Causes of Menstrual Irregularities
Menstrual irregularities can arise from various factors, including hormonal imbalances, stress, changes in weight, excessive exercise, and underlying medical conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders. In your girlfriend's case, the timeline of her menstrual cycles suggests that she may be experiencing anovulation or other hormonal fluctuations, especially since she has had a history of irregular cycles.

Pregnancy Considerations
Given that your girlfriend has taken multiple pregnancy tests, including an ultrasound, and all results have indicated that she is not pregnant, it is reasonable to conclude that the missed period is likely not due to pregnancy. However, it is important to note that pregnancy tests are most accurate when taken after a missed period, and false negatives can occur, especially if the tests are taken too early or if there are issues with the test itself.

Medication for Inducing Menstruation
The doctor prescribed medication to induce menstruation, which is a common approach for managing delayed periods. The effectiveness of these medications can vary based on several factors, including adherence to the prescribed regimen.
1. Effect of Incomplete Dosing: If your girlfriend has only taken the medication in the morning and skipped the evening dose, it may indeed reduce the effectiveness of the treatment. Medications for inducing menstruation often require consistent dosing to achieve the desired hormonal changes that trigger a period. Therefore, taking only half the prescribed dose may not provide the expected results.

2. Possible Outcomes: If the medication is not taken as directed, it is possible that her period may not come as anticipated. The body may require a full course of the medication to respond appropriately.
3. Follow-Up with the Doctor: Given the situation, it is advisable for your girlfriend to follow up with her healthcare provider. They can assess her response to the medication and determine if any adjustments are necessary. If her period does not start after completing the medication, further evaluation may be warranted to explore other underlying causes.

4. Recommendations for Regulating Menstrual Cycles: To help regulate menstrual cycles, lifestyle modifications can be beneficial. These may include maintaining a healthy diet, managing stress through relaxation techniques, regular exercise, and ensuring adequate sleep. If hormonal imbalances are suspected, the doctor may recommend further testing or alternative treatments, such as hormonal contraceptives, to help regulate her cycle.

Conclusion
In summary, menstrual irregularities can stem from various causes, and while pregnancy seems unlikely in your girlfriend's case, it is crucial to adhere to prescribed treatments for the best chance of restoring her menstrual cycle. If the current approach does not yield results, a follow-up with her healthcare provider is essential to explore further options and ensure her reproductive health is managed effectively.

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