Irregular Menstruation and Oral Health Issues After Pregnancy

Q: Irregular Menstruation and Oral Health Issues After Pregnancy

Hello Ms. Lin： 1. You are concerned about whether you might experience early menopause. I believe that your current test results are normal and show no abnormalities, so it is unlikely. 2. As for whether your body is lacking anything, it should not be

Menstrual issues

Hello Doctor, I recently gave birth nine and a half months ago.
I stopped breastfeeding about two months ago.
Around three months postpartum, I had a tooth extraction, and since then, I have been experiencing discomfort in my oral cavity.
I have a burning pain and swelling in the left oral mucosa, and my tongue has an abnormal taste sensation.
This has been ongoing for over seven months.
I have consulted many specialists, but no one has been able to identify the underlying cause.

Starting in March, my menstrual cycle became irregular.
In April, I had two menstrual periods, and in early May, I experienced abnormal bleeding.
I then visited a gynecologist and took the medication prescribed for menstrual regulation.
After three weeks of medication, my period returned for seven days, but the flow was very light and the duration was short.
Concerned about this irregularity, I went to a major hospital for further examination.
The doctor performed a transvaginal ultrasound and reported that there were no significant abnormalities in my ovaries or uterus, but noted that my endometrium was thin and suggested that I might not be ovulating.
I was advised to take hormonal therapy for three months to regulate my menstrual cycle.
I have completed the first cycle of the hormonal treatment, and the flow during my last period was slightly heavier, lasting about three days.
After completing the second cycle, my menstrual flow was only significant on the first day, with little to no flow thereafter.
I previously consulted a metabolic specialist who conducted blood tests, a 24-hour urine test, and a brain MRI 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 again showed no abnormalities.
The doctor recommended continuing the hormonal therapy and to return for blood tests in six months.
Additionally, I had my underarm hair removed in June, and it has not grown back since.
I am unsure what the underlying issue might be.
Could you help analyze my situation? Am I experiencing early menopause, hormonal imbalances, or deficiencies in certain nutrients? Could my oral symptoms be related to these issues, or is there a gynecological condition that has not been identified? I have also undergone a CT scan of the head and neck with contrast, which showed no abnormalities, and an MRI of the brain, which also showed no issues.

Currently, the only potential factor affecting my oral symptoms seems to be a neurological issue.
The primary concern remains my irregular menstrual cycle.
What further tests should I consider? I had a Pap smear earlier this year, which was normal, and I have a follow-up gynecological appointment in early September for my third hormonal treatment cycle, which started on July 31.
I have undergone numerous tests, including those for prolactin levels, which appeared normal.

I am uncertain why my menstrual cycle is behaving this way.
Is it possible that untreated oral symptoms are causing stress, which in turn affects my menstrual cycle? Or could there be issues with my uterus or ovaries? I am currently taking Rifampicin and Zanaflex; could these medications affect my hormones or menstrual cycle?
1.
Am I experiencing early menopause?
2.
Is my body lacking something essential?
3.
Could my oral symptoms be causing psychological stress, leading to menstrual irregularities?
4.
Do I need to undergo further vaginal examinations or other tests?
5.
Is there a possibility that I have a gynecological condition or cancer?
I apologize for the lengthy message, and I appreciate your patience in reading it.
Thank you for your kindness and expertise.

Miss Lin, 40~49 year old female. Ask Date: 2019/08/03

Dr. Huang Yiwen reply Obstetrics and Gynecology

Hello Ms.
Lin:
1.
You are concerned about whether you might experience early menopause.
I believe that your current test results are normal and show no abnormalities, so it is unlikely.

2.
As for whether your body is lacking anything, it should not be the case; at least that is what the current medical tests indicate.

3.
It is quite difficult to determine if oral symptoms could affect psychological stress and cause menstrual irregularities; this also depends on the severity of the condition.

4.
It seems that you have already undergone most of the necessary tests.
My suggestion is to patiently complete the third course of your menstrual regulation medication before reassessing the situation.

5.
Menstrual irregularities are quite common among females, so there is no need to worry too much, and it is certainly not cancer.

Reply Date: 2019/08/03

More Info

Dear Patient,
Thank you for sharing your concerns regarding your health after childbirth. It sounds like you are experiencing a complex interplay of symptoms that are affecting both your oral health and menstrual cycle. Let's break down your questions and concerns systematically.

1. Early Menopause: The symptoms you describe, including irregular menstruation and changes in your menstrual flow, could potentially indicate early menopause or hormonal imbalances. However, it is essential to consider that postpartum hormonal fluctuations are common and can take time to stabilize. The fact that you are undergoing hormone therapy suggests that your healthcare provider is addressing these concerns. Monitoring your symptoms over the next few months will be crucial in determining if this is a temporary phase or a sign of early menopause.

2. Nutritional Deficiencies: Hormonal imbalances can sometimes be linked to nutritional deficiencies. After childbirth, women may experience changes in their dietary habits or may not be getting adequate nutrition, especially if they are breastfeeding or recovering from childbirth. It might be beneficial to evaluate your diet and consider consulting a nutritionist to ensure you are getting sufficient vitamins and minerals, particularly those that support hormonal health, such as vitamin D, B vitamins, and omega-3 fatty acids.

3. Psychological Stress and Oral Health: Stress can significantly impact both oral health and menstrual cycles. The discomfort you are experiencing in your oral cavity, such as burning sensations and abnormal taste, could be exacerbated by stress. Chronic stress can lead to conditions like bruxism (teeth grinding), which may contribute to oral discomfort. Additionally, stress can disrupt hormonal balance, potentially leading to irregular menstrual cycles. It is essential to address stress through relaxation techniques, counseling, or other supportive measures.

4. Need for Further Investigations: Given the complexity of your symptoms, it may be worthwhile to discuss with your healthcare provider the possibility of further investigations. This could include additional blood tests to evaluate hormone levels, thyroid function, and other metabolic markers. If you have not already, a thorough gynecological examination may also be beneficial to rule out any underlying conditions that could be affecting your menstrual cycle.

5. Concerns About Gynecological Issues: While it is understandable to be concerned about potential gynecological issues or cancers, the tests you have undergone, including ultrasounds and pap smears, are typically effective in identifying significant abnormalities. If you have any new or concerning symptoms, such as unusual discharge, severe pain, or changes in your menstrual cycle, it is essential to communicate these to your healthcare provider promptly.

In conclusion, your symptoms may be interconnected, and a holistic approach to your health is essential. Continue to work closely with your healthcare providers, and do not hesitate to seek further evaluations if your symptoms persist or worsen. Remember that recovery and hormonal balance can take time, especially after significant life changes like childbirth. Prioritize self-care, manage stress, and ensure you are nourishing your body adequately during this period.

Wishing you good health and peace of mind as you navigate these challenges.

Best regards.

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