Menstrual Irregularities After Pregnancy: Causes and Concerns

Menstrual issues

Hello, doctor.
I have detailed my issues in #148845.
Here are my questions: I am currently nine and a half months postpartum and stopped breastfeeding about two months ago.
Around three months postpartum, I had a tooth extraction, and since then, I have experienced discomfort in my oral cavity.
The left side of my oral mucosa has a burning pain, and my tongue has an abnormal taste sensation.
I have seen many specialists, but no one has been able to identify the underlying cause.
Since March, my menstrual cycle has become irregular; in April, I had two periods, and in early May, I experienced abnormal bleeding.
I then visited a gynecologist and took the medication prescribed for regulation.
After taking the medication for three weeks, my period returned for seven days, but the flow was very light and the duration was short.
I felt this was unusual, so I went to a larger hospital for further examination.
The doctor performed a transvaginal ultrasound and found no significant abnormalities in my ovaries or uterus, but noted that my endometrium was thin and suspected I was not ovulating.
I was advised to take hormonal treatment for three months to regulate my menstrual cycle.
I have completed the first 21-day treatment cycle, and my menstrual flow was slightly heavier this time, lasting about three days.
After completing the second treatment cycle, my period was only heavy on the first day, and by the second day, it felt like it had stopped.
I previously consulted a metabolic specialist who conducted blood tests, a 24-hour urine test, and an MRI of my brain with contrast, all of which showed no abnormalities in the brain.
However, some blood test results were slightly off, leading the doctor to suspect ovarian dysfunction or issues with the ovaries.
On June 4th, I had another transvaginal ultrasound, which showed no abnormalities, so the doctor advised me to continue the hormonal treatment and return for blood tests in six months.
Additionally, in June, I shaved my underarm hair, and it has not grown back since.
I am unsure what the underlying issue is.
Can you help analyze my situation?
Answer: There doesn't seem to be any significant problems (this is what the doctor said).
PS: (I don't understand what the doctor meant).
Am I experiencing early menopause, hormonal issues, or a deficiency of some kind? Could my oral symptoms be related to these issues, or could there be a gynecological condition? I have already undergone a CT scan of the head and neck with contrast, which showed no abnormalities in the oral cavity, and I also had an MRI of the head that showed no issues.
The only thing that seems to potentially affect my oral symptoms is a neurological issue.
Currently, the only concern is my irregular menstrual cycle.
What further tests should I undergo? I had a Pap smear this year, which was normal, and I have a follow-up gynecological appointment in early September for my third hormonal treatment cycle, which I started on July 31.
I have undergone many tests, including for prolactin, which also seemed normal, but I am unsure why my menstrual cycle is like this.
Is it possible that the untreated oral symptoms are causing these issues, or could it be stress, or problems with my uterus or ovaries? What does PS represent? Is everything I mentioned a possibility? I apologize for the trouble, and thank you.

Miss Lin, 40~49 year old female. Ask Date: 2019/08/02

Dr. Huang Jianzhong reply Obstetrics and Gynecology

PS stands for postscript, which is an additional remark or note added after the main content, rather than a response.

Reply Date: 2019/08/02

More Info

Understanding menstrual irregularities after pregnancy can be a complex issue, especially when compounded by other health concerns. In your case, it seems you are experiencing a combination of symptoms that may be interrelated. Let’s break down the potential causes and concerns regarding your menstrual irregularities, oral discomfort, and overall health.

Firstly, it’s important to recognize that after childbirth, many women experience changes in their menstrual cycles. This can be due to hormonal fluctuations, especially if breastfeeding has ceased. The hormonal balance can take time to stabilize, and it’s not uncommon for menstrual cycles to be irregular during this period. The fact that you stopped breastfeeding around two months postpartum could have contributed to these irregularities. Hormones such as estrogen and progesterone play significant roles in regulating the menstrual cycle, and their levels can fluctuate significantly after pregnancy.

You mentioned that you experienced abnormal bleeding and irregular cycles, which led to consultations with various specialists. The thin endometrial lining noted during your ultrasound could indicate that your body is not producing enough estrogen, which is necessary for building the uterine lining. This could explain the light menstrual flow you are experiencing. Hormonal therapy, as prescribed, is often a standard approach to help regulate menstrual cycles and promote a healthier endometrial lining.

Regarding your oral symptoms, such as burning sensations and altered taste, these could potentially be linked to several factors. Stress is known to exacerbate various physical symptoms, including oral discomfort. Additionally, hormonal changes can also affect oral health, leading to conditions like dry mouth or changes in taste perception. It’s essential to address these symptoms with your healthcare provider, as they could be indicative of an underlying condition that requires attention.

You also raised concerns about early menopause or ovarian dysfunction. While it’s understandable to worry about these possibilities, it’s crucial to remember that many factors can influence ovarian function, including stress, hormonal imbalances, and overall health. The tests you’ve undergone, including blood tests and imaging, have not indicated any significant abnormalities, which is a positive sign. However, continued monitoring and follow-up with your healthcare provider are essential to ensure that any changes in your health are addressed promptly.

As for the lack of hair regrowth after shaving, this could be related to hormonal changes as well. Hormones play a significant role in hair growth, and fluctuations can lead to temporary changes in hair growth patterns. If this persists, it may warrant further investigation.

In summary, your symptoms could be interrelated, stemming from hormonal changes post-pregnancy, stress, and possibly other underlying health issues. It’s essential to maintain open communication with your healthcare providers, continue with the prescribed hormonal therapy, and monitor your symptoms closely. If you notice any significant changes or worsening of your symptoms, do not hesitate to seek further evaluation.

Lastly, regarding your question about "PS," it typically stands for "postscript," which is used to add additional information after the main content. In this context, it seems you are seeking clarification on whether the concerns you mentioned could all be interconnected. Yes, they could be, and it’s essential to consider the holistic picture of your health when addressing these issues.
If you have further questions or concerns, please feel free to reach out to your healthcare provider for personalized advice and support. Your health and well-being are paramount, and it’s crucial to address any issues comprehensively.

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