Why Your Period Might Be Delayed After Taking Menstrual Medications

Taking menstrual regulation medication but still no menstruation?

Hello Doctor, I have been taking menstrual regulation medication for a long time, but due to some factors, I switched clinics to get my medication.
The new doctor told me that the medication he prescribed has the same ingredients and effects as the one prescribed by the previous doctor, just a different brand.
I am taking two types of menstrual regulation medication! The medication from the original clinic was: starting on the third day of my period, I took a five-day course of CLOMIPHENE CAPSULES “YU” (active ingredient: CLOMIPHENE CITRATE 50MG), and then after ovulation, I took a seven-day course of SHITON S.C.
TABLETS “YU SHEN” (active ingredient: NORETHINDRONE 5MG).
The medication from the new clinic is: starting on the third day of my period, I take a five-day course of CLOMIPHENE TABLET (active ingredient: CLOMIPHENE CITRATE), and then after ovulation, I take a seven-day course of NORDRON S.C.
TABLE (active ingredient: NORETHINDRONE ACETATE).

Last month, my period was from March 5 to March 11, and I took the menstrual regulation medication during that time.
On March 26, I took medication to induce my period.
Based on my previous experience with the medication, my period usually arrives on the third day after taking the inducing medication.
However, I started taking the inducing medication on March 26 and continued until April 1.
Normally, I would expect my period to arrive by April 4, but today is April 6, and it still hasn’t come...

I would like to ask if the reason for my missed period could be due to the fact that I just started taking the new clinic's medication in March, but I have also been under a lot of stress, averaging only 3-4 hours of sleep per night.
Could the long-term lack of sleep, irregular schedule, and stress be the reasons for not getting my period even after taking the inducing medication?
Additionally, I would like to inquire about the likelihood of pregnancy.
The dates of sexual activity last month were: unprotected intercourse on March 16, protected intercourse on March 23, and unprotected intercourse on March 31.
What is the probability of pregnancy in this situation?

Niming, 10~19 year old female. Ask Date: 2019/04/06

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I just started taking medication from a new clinic in March, but my stress levels have increased significantly since then.
On average, I only get about 3-4 hours of sleep per night.
Could the reason for not getting my period be due to long-term sleep deprivation, irregular sleep patterns, and stress, even after taking the menstrual induction medication?
Regarding the dates of sexual intercourse: on March 16, I had unprotected sex; on March 23, I had protected sex; and on March 31, I had unprotected sex.
What is the likelihood of pregnancy?
I am taking the ovulation medication CLOMIPHENE CITRATE to increase my chances of getting pregnant.

Reply Date: 2019/04/06

More Info

When it comes to delayed menstruation after taking menstrual medications, several factors can contribute to this phenomenon. In your case, you have been prescribed medications that include Clomiphene Citrate and Norethindrone, which are commonly used for regulating menstrual cycles and inducing ovulation. However, the transition to a new clinic and the associated stressors may have impacted your menstrual cycle.

Understanding the Medications:
1. Clomiphene Citrate: This medication is often used to stimulate ovulation in women who have irregular or absent menstrual cycles. It works by blocking estrogen receptors in the hypothalamus, which in turn stimulates the release of hormones that promote ovulation.

2. Norethindrone: This is a synthetic form of progesterone, which helps to regulate the menstrual cycle and can also be used to treat conditions like endometriosis or abnormal uterine bleeding.

Factors Contributing to Delayed Menstruation:
1. Stress: High levels of stress can significantly affect hormonal balance and disrupt the menstrual cycle. Stress can lead to the release of cortisol, which may inhibit the production of reproductive hormones, thus delaying ovulation and menstruation.

2. Sleep Deprivation: Chronic lack of sleep can also affect hormonal regulation. Sleep is crucial for maintaining a healthy endocrine system, and insufficient sleep can lead to irregularities in the menstrual cycle.

3. Changes in Medication: Switching medications, even if the active ingredients are the same, can lead to variations in how your body responds. Different formulations or brands may have different inactive ingredients that could affect absorption or efficacy.

4. Body Weight and Lifestyle Changes: Significant changes in weight, diet, or exercise can also impact menstrual regularity.
Pregnancy Considerations:
Regarding your sexual activity, it is important to consider the timing of ovulation. If you had unprotected intercourse on March 16 and March 31, there is a possibility of pregnancy, especially if ovulation occurred around that time. The typical ovulation window is about 14 days before your next expected period, but this can vary based on individual cycles. If your period does not arrive soon, it may be prudent to take a pregnancy test to rule out pregnancy.

What to Do Next:
1. Monitor Symptoms: Keep track of any additional symptoms you may experience, such as breast tenderness, nausea, or fatigue, which could indicate pregnancy or hormonal changes.

2. Consult Your Doctor: If your period does not arrive within a week or two, consider reaching out to your healthcare provider. They may recommend a pregnancy test or further evaluation to understand the cause of the delay.

3. Manage Stress and Sleep: Implementing stress-reduction techniques such as mindfulness, yoga, or regular exercise can help. Additionally, prioritizing sleep hygiene may improve your overall well-being and potentially regulate your menstrual cycle.

In summary, while hormonal medications can effectively regulate menstrual cycles, external factors such as stress, sleep deprivation, and changes in medication can also play a significant role in menstrual irregularities. If you have concerns about your menstrual health or potential pregnancy, it is always best to consult with a healthcare professional for personalized advice and management.

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