Irregular Menstrual Cycles After Medication: Key Insights

Q: Irregular Menstrual Cycles After Medication: Key Insights

The general procedure is as follows： 1. <br>Administer uterine contraction medication to control bleeding; 2. <br>After bleeding is controlled, perform a transvaginal ultrasound examination (can be done in an outpatient setting); 3. <br>If there is thickening of the endometrium o

Case number #171574 - Signs of continuous menstruation?

Hello, Doctor.
I am the patient from case number #171574.
Regarding the previous issue: I visited the clinic on July 20, 2021, to check for polycystic ovary syndrome due to not having my menstrual cycle for three months.
I also took medication to induce menstruation (Provera) from July 20 to July 25.
My period started with a very light flow on July 29-30, but then suddenly became heavy from July 31 to August 2, accompanied by lower abdominal discomfort and a feeling of dizziness.
Previously, when I took medication to induce menstruation, I usually experienced heavy flow on the first three days, with a decrease by the fourth day.
However, this time, the first two days had light flow, followed by heavy flow from days three to five.
Is this heavy menstrual flow related to the medication I took to induce my period? Thank you for your assistance, Doctor.

You have already responded, but I would like to ask now that as of today, August 4, I am still experiencing heavy menstrual flow: 1.
Should I undergo an ultrasound or a hysteroscopy? 2.
If a hysteroscopy is needed, can it be performed as an outpatient procedure? (I am concerned about the possibility of polyps in the uterus.)

Miss Zhou, 30~39 year old female. Ask Date: 2021/08/04

Dr. Wu Xianghui reply Obstetrics and Gynecology

The general procedure is as follows: 1.
Administer uterine contraction medication to control bleeding; 2.
After bleeding is controlled, perform a transvaginal ultrasound examination (can be done in an outpatient setting); 3.
If there is thickening of the endometrium or polyp-like lesions, schedule a hysteroscopy (requires an outpatient surgical room).

Reply Date: 2021/08/04

More Info

Irregular menstrual cycles can often be a source of concern for many women, especially after taking medications such as hormonal treatments. In your case, it seems that you have experienced a significant change in your menstrual pattern following the use of Provera (medroxyprogesterone), which is commonly prescribed to induce menstruation.
When you take Provera, it works by mimicking the natural hormone progesterone in your body, which can help to regulate your menstrual cycle. The irregularities you are experiencing, such as the sudden increase in menstrual flow and accompanying symptoms like abdominal discomfort and dizziness, can indeed be related to the medication. It is not uncommon for women to experience variations in their menstrual cycles after taking hormonal medications, as the body adjusts to the changes in hormone levels.

Regarding your specific questions:
1. Ultrasound or Hysteroscopy: Given that you are experiencing heavy menstrual bleeding (menorrhagia) and discomfort, it would be prudent to undergo further evaluation. An ultrasound can help assess the structure of your uterus and ovaries, checking for any abnormalities such as fibroids or cysts. If there is a suspicion of intrauterine pathology, such as polyps or other growths, a hysteroscopy may be warranted. This procedure allows for direct visualization of the uterine cavity and can often be performed in an outpatient setting. It can also allow for the removal of any identified polyps or other abnormalities during the same procedure.

2. Outpatient Procedure: Hysteroscopy is typically performed as an outpatient procedure, meaning you would not need to stay overnight in the hospital. It can be done with local anesthesia, sedation, or general anesthesia, depending on the complexity of the case and your comfort level. The procedure is relatively quick, and many women report minimal discomfort afterward. If polyps or fibroids are found, they can often be removed during the hysteroscopy, which can help alleviate symptoms and regulate your menstrual cycle.

In summary, the irregularities in your menstrual cycle following the use of Provera are likely related to the hormonal changes induced by the medication. Given your ongoing symptoms, it is advisable to consult with your healthcare provider about the possibility of an ultrasound and potentially a hysteroscopy to rule out any underlying conditions. Monitoring your symptoms closely and seeking timely medical advice will be crucial in managing your menstrual health effectively.
Additionally, if you continue to experience heavy bleeding, severe pain, or any other concerning symptoms, do not hesitate to seek immediate medical attention. Your health and well-being are paramount, and addressing these issues early can lead to better outcomes.

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