Missed Period After Birth Control: When to Consult Your Gynecologist?

Oral contraceptives are used to regulate menstrual cycles, but if menstruation does not occur after discontinuation of the medication, it may indicate a condition such as post-pill amenorrhea?

Hello, doctor.
Let me explain my situation.
I went to the gynecologist and was diagnosed with polycystic ovary syndrome (PCOS).
The doctor recommended that I take birth control pills (Diane) to regulate my menstrual cycle.
I took them for the first three months, during which my periods were normal.
After that, the doctor said I could stop the medication to give my ovaries a rest, but after stopping, my period still did not come.
Eventually, I received a progesterone injection to induce my period.
I then started taking the birth control pills again for another three months.
In July, the doctor said I could stop the medication to allow my ovaries to rest again, but by August, my period was already seven days late and still hasn't arrived.
Should I wait a few more days before returning to the gynecologist for menstrual induction, or should I go back to the gynecologist for an examination directly? Also, how many days of a missed period are considered normal, and when should I see a doctor? Thank you.

Olivia, 20~29 year old female. Ask Date: 2020/08/16

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if it doesn't come after another week, it is advisable to see a gynecologist.
Wishing you good health.

Reply Date: 2020/08/16

More Info

When it comes to missed periods after stopping birth control, especially in the context of polycystic ovary syndrome (PCOS), it’s essential to understand both the physiological and medical implications of your situation.
First, it’s important to recognize that hormonal contraceptives, such as the pill you mentioned (Diane-35), are often used to regulate menstrual cycles in women with PCOS. These medications work by providing consistent hormone levels, which can help manage symptoms like irregular periods. However, once you stop taking the pill, your body may take some time to readjust and resume its natural hormonal rhythm. This adjustment period can vary significantly from person to person.

In your case, after stopping the birth control pill, you experienced a delay in your menstrual cycle, which is not uncommon. The fact that you had to take progesterone (like the one you mentioned, which is likely a form of progestin) to induce a period indicates that your body may not have been producing enough progesterone on its own to trigger menstruation. This can be particularly relevant for women with PCOS, as they often have hormonal imbalances that can lead to anovulation (the absence of ovulation), which in turn can cause missed periods.

Now, regarding your question about when to consult your gynecologist: If your period is more than a week late after stopping the birth control, it is generally advisable to reach out to your healthcare provider. While some variability can be expected, especially after stopping hormonal contraceptives, a delay of more than a week may warrant further evaluation. Your doctor may want to check for underlying issues, such as hormonal imbalances or other conditions that could be affecting your menstrual cycle.

As for the question of how long to wait before consulting a doctor, it’s typically considered normal to have a delay of a few days to a week after stopping birth control. However, if you find that your cycle remains irregular or you experience other symptoms (such as significant weight changes, excessive hair growth, or severe acne), it’s best to seek medical advice sooner rather than later.
In summary, given your history of PCOS and the use of hormonal contraceptives, it’s not unusual to experience missed periods after stopping the pill. However, if your period is delayed by more than a week, or if you have concerns about your menstrual health, it’s wise to consult your gynecologist. They can provide tailored advice and may suggest further testing or treatment options to help regulate your cycle and manage your PCOS symptoms effectively. Remember, maintaining open communication with your healthcare provider is key to managing your reproductive health.

Similar Q&A

Missed Period After Stopping Birth Control: What Should You Do?

Hello, doctor: I have been taking oral contraceptives regularly to ensure that my menstrual cycle comes smoothly every month. I stopped taking the pills in July, and my period came on time in August. However, in September, my period was almost two weeks late. During this time, I ...

Dr. Wu Xianghui reply Obstetrics and Gynecology
For pregnancy concerns, please perform a home pregnancy test or consult a specialist in obstetrics and gynecology for evaluation four weeks after sexual intercourse.

Missed Period After Stopping Birth Control: When to See a Doctor?

1. I have been taking Dailian for a year, and my menstrual cycles have been regular during that time. This month, I decided to take a break and stopped for the first month. I expected my period to start on the 14th, but it hasn't come yet, and today is the 16th. Should I see...

Dr. Chen Zhiyu reply Obstetrics and Gynecology
For the use and discontinuation of contraceptive pills, please consult a gynecologist. It is generally not recommended to mix medications. Thank you.

Missed Period After Stopping Birth Control: What You Need to Know

Hello, doctor. I have been taking the contraceptive pill Qlaira (21 pills) for a year and a half. The doctor who prescribed it advised me to stop taking the medication for one month after every three months of use. My menstrual periods for the first three cycles were on March 13,...

Dr. Wu Xianghui reply Obstetrics and Gynecology
1. For pregnancy concerns, please take a home pregnancy test or visit a gynecologist for examination and evaluation four weeks after your most recent sexual intercourse. 2. The menstrual cycle can be affected by various psychological and physiological factors; if your period is m...

Missed Period After Birth Control: What You Need to Know

Hello, Doctor: I would like to ask you a question. I started taking birth control pills (Kiryana) for the first time at the end of September, taking a 21-pill pack. The main reason I wanted to take birth control pills was to try having unprotected sex with my boyfriend. After fin...

Dr. Zhang Kunmin reply Obstetrics and Gynecology
Hello, the factors that can affect the menstrual cycle are numerous, including age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraception, diet, polycystic ovary syndrome, lesions of the uterus or cervix, infections, ovulation...