Missed Period After Hormone Therapy: What Should You Do Next?

It has been over 8 days since finishing the menstrual regulation medication, and menstruation has not occurred?

Hello, due to early menopause, my doctor prescribed me HRT (hormone replacement therapy) with Xinna tablets, which I take for 21 days followed by a 7-day break.
Initially, my period would start on the 22nd or 23rd day, but recently it has been getting later.
This time, I completed a full 28-day cycle and my period still hasn't come, so I started taking the medication for the next cycle on the first day.
However, after taking the first pill, I noticed that my period seems to be about to start.
Should I continue taking the medication for the next cycle and stop when I see bleeding, or should I stop taking the medication altogether and wait for my period to come and finish before starting the medication again? Thank you for your response.

Xiao Mi, 30~39 year old female. Ask Date: 2020/05/29

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, continue taking the medication without stopping.
Generally, menstruation will occur within a week after finishing the medication.
Wishing you good health.

Reply Date: 2020/05/29

More Info

When dealing with missed periods after starting hormone therapy, it's essential to approach the situation with caution and an understanding of how hormone replacement therapy (HRT) works. In your case, you have been prescribed HRT (specifically, a medication like "欣娜錠") to manage symptoms related to early menopause. This therapy is designed to help regulate your menstrual cycle and alleviate symptoms associated with hormonal imbalances.

First, it's important to recognize that hormone therapy can sometimes lead to irregularities in your menstrual cycle, especially in the initial stages of treatment. It is not uncommon for women to experience variations in the timing of their periods when they first start taking HRT. The fact that your periods were initially regular and have since become delayed could be attributed to your body adjusting to the hormone levels introduced by the medication.

Given that you have completed a full cycle of the medication and have not had your period, it is understandable that you are concerned. However, before making any decisions about continuing or stopping your medication, consider the following steps:
1. Wait for Your Body's Response: Since you mentioned that you started to feel like your period was about to come after taking the first pill of the new cycle, it may be beneficial to wait and see if your period arrives. If you experience bleeding, it would be a sign that your body is responding to the hormone therapy.

2. Continue the Medication: If you have not yet started bleeding, you might consider continuing with the medication for the time being. Hormone therapy is often designed to be taken consistently, and stopping it abruptly can lead to further hormonal imbalances. If your period starts while you are taking the medication, you can stop taking it until your bleeding has concluded.

3. Monitor Symptoms: Pay attention to any additional symptoms you may experience, such as mood changes, physical discomfort, or other signs that could indicate hormonal fluctuations. This information can be valuable for your healthcare provider.

4. Consult Your Healthcare Provider: If your period does not arrive soon or if you have concerns about the missed period, it is crucial to consult with your healthcare provider. They can assess your situation more thoroughly, possibly adjusting your medication or exploring other underlying causes for the missed period.

5. Consider Other Factors: Remember that various factors can influence your menstrual cycle, including stress, changes in weight, and other health conditions. If you have experienced significant life changes or stressors, these could also contribute to irregularities in your cycle.

In summary, while it is tempting to adjust your medication based on the missed period, it is generally advisable to continue taking the hormone therapy as prescribed until you have more clarity on your menstrual cycle. If you do experience your period, you can then pause the medication until the bleeding has stopped. Always keep an open line of communication with your healthcare provider, as they can provide personalized guidance based on your specific health needs and circumstances.

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