Irregular Periods: When to Seek Medical Advice

Amenorrhea

Hello Doctor: I am married and have a daughter.
I originally had an intrauterine device (IUD) for contraception, and my menstrual cycle was always regular.
However, since my last period on November 8, 2002, I have not had another one.
On December 24, 2002, I visited a gynecologist for an examination, and I was not pregnant.
The doctor mentioned that the IUD had shifted, so it was removed, and I was given a medication to induce menstruation.
As of January 2, 2003, my period still had not arrived, so I went back to the gynecologist.
The doctor performed a urine test, confirmed I was not pregnant, and prescribed medication to induce menstruation again, instructing me to take it for a week and then wait another week.
If my period still did not come, I was advised to return for further examination.
However, I have recently noticed that my lower abdomen has become enlarged.
I am unsure whether I should go back to the hospital for a thorough examination now or wait until after I finish the medication in a week before checking again.

Yun Yun, 20~29 year old female. Ask Date: 2003/01/06

Dr. Zhan Deqin reply Obstetrics and Gynecology

If your menstruation has not occurred for an extended period and you notice abdominal swelling, it is advisable to undergo a thorough examination as soon as possible; it is not wise to delay further.

Reply Date: 2003/01/06

More Info

When it comes to irregular periods and the accompanying symptoms, it is essential to understand the underlying causes and when to seek medical advice. Based on your situation, it appears that you have experienced a significant change in your menstrual cycle after the removal of your intrauterine device (IUD). This can be concerning, especially since you have not had a period since your last one on November 8th, and you have noticed abdominal enlargement.

Firstly, it is important to recognize that hormonal changes can occur after the removal of an IUD, which can lead to irregular menstrual cycles. The body may take some time to readjust and return to its normal hormonal balance. However, the absence of menstruation for an extended period, especially after a previous regular cycle, warrants further investigation.

You mentioned that you received a medication to induce menstruation, which is a common approach when a woman has not had her period for a while. If you have taken the medication as prescribed and still do not see any signs of menstruation after the waiting period, it is advisable to follow up with your healthcare provider. The fact that you are experiencing abdominal enlargement is also a symptom that should not be overlooked. This could indicate various conditions, including hormonal imbalances, ovarian cysts, or even other underlying issues that may require further evaluation.

In terms of when to seek medical advice, here are some guidelines:
1. Prolonged Absence of Menstruation: If you have not had a period for more than three months (amenorrhea), it is essential to consult with a healthcare provider, especially if you have already taken medication to induce menstruation.

2. Abdominal Enlargement: Any noticeable change in your abdominal size or shape, especially if it is accompanied by discomfort, pain, or other unusual symptoms, should prompt a visit to the doctor. This could indicate the presence of cysts, fibroids, or other conditions that may need to be addressed.

3. Other Symptoms: If you experience additional symptoms such as severe pain, unusual discharge, or any signs of infection (fever, chills, etc.), you should seek medical attention promptly.

4. Follow-Up on Treatment: Since you have already started a course of medication to induce your period, it is crucial to monitor your response to the treatment. If you do not see any improvement after the medication course, you should return to your healthcare provider for further evaluation.

In conclusion, while hormonal fluctuations after IUD removal can lead to irregular periods, the absence of menstruation for an extended period, especially with abdominal enlargement, is a valid reason to seek medical advice. It is better to err on the side of caution and ensure that there are no underlying issues that need to be addressed. Your health and well-being are paramount, and timely medical intervention can help identify and manage any potential concerns effectively.

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