Menstrual Irregularities: When to Seek Help

Menstrual concerns?

Hello, my last menstrual period started on June 10, and my last sexual intercourse was on July 8.
Since my period has not arrived, I visited a gynecologist on July 12, and the pregnancy test came back negative.
I should mention that I am a patient with systemic lupus erythematosus (SLE) and am currently managing my condition with medication (I am not on dialysis).
The gynecologist was concerned that menstruation-inducing medication might affect my lupus, so they advised against it for now and suggested that if my period does not come by the end of the month, I should take another test.
Since I still have not had my period (I have not had any sexual intercourse since July 12), I took a home pregnancy test on July 22 using both a test strip and a test stick, both of which indicated that I am not pregnant.
I would like to ask, in this situation, when can I expect my period to arrive? Should I continue to wait, or would it be better to ask the gynecologist for medication to induce my period? Will my period come, or is it possible that it will not come at all?

Niming, 20~29 year old female. Ask Date: 2018/07/29

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The last menstrual period started on June 10, and the last sexual intercourse occurred on July 8.
Since menstruation has not occurred, I visited a gynecologist on July 12, and the pregnancy test was negative.
I informed the doctor that I am a patient with systemic lupus erythematosus (SLE) and am currently managing my condition (only taking medication, no dialysis).
The gynecologist was concerned that hormonal medication might affect my lupus condition, so they did not prescribe any medication to induce menstruation.
They advised that if my period does not come by the end of the month, I should take another test.
Since I still have not had my period (no sexual intercourse since July 12), I took a home pregnancy test on July 22 using both a test strip and a test stick, both of which indicated that I am not pregnant.

I would like to ask:
1.
In this situation, when can I expect my period to come?
Answer: It is difficult to predict when menstruation will occur.

2.
Should I continue to wait, or is it better to ask the gynecologist for medication to induce menstruation?
Answer: It is better to continue waiting.

3.
Will my period come, or is it possible that it will not come at all?
Answer: Continue to wait for three months; if menstruation does not occur, then consult the gynecologist about inducing menstruation.

Reply Date: 2018/07/29

More Info

Menstrual irregularities can be concerning, especially for individuals with underlying health conditions such as systemic lupus erythematosus (SLE), which you mentioned you have. Your situation involves a missed period since June 10, with a negative pregnancy test on July 12 and subsequent home tests confirming you are not pregnant. Given your medical history and current health status, it is essential to approach this matter with care.

Firstly, it is not uncommon for women to experience irregular menstrual cycles due to various factors, including stress, hormonal imbalances, weight changes, and underlying medical conditions. In your case, the lupus itself can affect menstrual regularity. The medications you are taking to manage your lupus may also influence your menstrual cycle. Some medications can cause changes in hormone levels, leading to missed periods or irregular cycles.

Since your last menstrual period was on June 10 and you have not had any bleeding since, it is understandable to be anxious about when your period will return. The fact that you have had negative pregnancy tests is reassuring, but it does not necessarily explain the absence of menstruation. It is important to note that menstrual cycles can vary significantly from month to month, and sometimes it may take longer for your cycle to return to normal, particularly after a period of stress or illness.

Regarding your question about whether to wait for your period to return naturally or to seek medication to induce menstruation, there are several factors to consider. If your healthcare provider has advised against using hormonal treatments due to concerns about your lupus, it may be wise to follow their guidance. Inducing menstruation with medication can sometimes lead to complications, especially in patients with autoimmune conditions.
If your period does not return by the end of July, it would be prudent to follow up with your gynecologist. They may want to conduct further evaluations, such as blood tests to check hormone levels, or an ultrasound to assess the health of your reproductive organs. These tests can help determine if there are any underlying issues that need to be addressed.

In the meantime, it is essential to monitor your body for any other symptoms that may arise, such as unusual pain, significant weight changes, or other signs of hormonal imbalance. Keeping a record of your menstrual cycle, including any symptoms you experience, can be helpful for your healthcare provider in making a diagnosis.

In summary, while it is normal to feel anxious about a missed period, especially with your medical history, it is essential to communicate openly with your healthcare provider. They can provide personalized advice based on your overall health and specific circumstances. If your period does not return soon, or if you experience any concerning symptoms, do not hesitate to seek further medical advice. Your health and well-being should always be the priority.

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