Why Your Period Might Not Return After Taking Menstrual Induction Pills

Taking menstrual induction medication but no menstruation has occurred?

The last menstrual period was on November 29, 2021, and it has been 55 days without menstruation.
There was a very small amount of brown discharge between December 21-24.
On January 14, 2022, I visited a gynecologist, and a pregnancy test was negative.
The doctor prescribed a three-day course of medication to induce menstruation and advised that my period would arrive within seven days after completing the medication (no ultrasound was performed).
However, it has now been a full seven days, and my period has still not arrived.

I would like to ask the doctor if there is still a possibility of pregnancy after confirming that I am not pregnant.
Could the absence of menstruation be due to other issues, and should I continue to wait? (After finishing the medication to induce menstruation, I consulted a traditional Chinese medicine practitioner who suspects polycystic ovary syndrome.)

Lin, 10~19 year old female. Ask Date: 2022/01/23

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
If the endometrial thickness is insufficient (it is recommended to use ultrasound for assessment), the efficacy of menstruation induction may be poor.
2.
The management of polycystic ovary syndrome varies based on individual needs; it is advisable to consult other physicians for opinions.

Reply Date: 2022/01/23

More Info

The situation you are describing regarding the absence of menstruation after taking menstrual induction pills can be quite complex and may involve several factors. First, it is essential to understand that menstrual irregularities can arise from various causes, including hormonal imbalances, stress, lifestyle changes, and underlying medical conditions such as polycystic ovary syndrome (PCOS), which your traditional Chinese medicine practitioner has suggested.

When you take menstrual induction pills, they are designed to stimulate the lining of the uterus to shed, mimicking the natural menstrual cycle. However, if your body is experiencing hormonal imbalances or other underlying issues, the expected response to these medications may not occur. Here are some potential reasons why your period might not return after taking these pills:
1. Hormonal Imbalance: The menstrual cycle is regulated by a complex interplay of hormones, including estrogen and progesterone. If there is an imbalance, it can affect ovulation and the menstrual cycle. Conditions like PCOS often lead to elevated levels of androgens (male hormones), which can disrupt the normal hormonal balance and lead to irregular or absent periods.

2. Stress and Lifestyle Factors: High levels of stress, significant weight changes, excessive exercise, or poor nutrition can all impact your menstrual cycle. Stress can lead to elevated cortisol levels, which can interfere with the hormones that regulate menstruation.

3. Underlying Medical Conditions: Besides PCOS, other conditions such as thyroid disorders, hyperprolactinemia (high levels of prolactin), or even certain chronic illnesses can affect menstrual regularity. If you have not had a thorough evaluation, it might be worth discussing further tests with your healthcare provider.

4. Response to Medication: Not all individuals respond to menstrual induction pills in the same way. Some may require a longer time for the medication to take effect, while others may not respond at all if there are significant hormonal imbalances.

5. Pregnancy Considerations: Although you have confirmed that you are not pregnant, it is essential to note that some tests may not detect very early pregnancies. If there is any doubt, a follow-up pregnancy test or a blood test for pregnancy (which is more sensitive) might be warranted.

Given that you have already taken the induction medication and have not seen a return of your period, it is advisable to follow up with your healthcare provider. They may recommend further evaluation, including blood tests to check hormone levels, an ultrasound to assess the ovaries and uterus, or other diagnostic procedures to determine the underlying cause of your amenorrhea (absence of menstruation).

In the meantime, if you suspect PCOS, it may be beneficial to discuss lifestyle modifications, such as diet and exercise, which can help manage symptoms associated with this condition. Additionally, if you are experiencing significant distress or anxiety regarding your menstrual health, consider seeking support from a mental health professional.

In summary, while menstrual induction pills can help trigger a period, various factors can influence their effectiveness. It is crucial to work closely with your healthcare provider to identify the underlying cause of your menstrual irregularities and develop a tailored treatment plan that addresses your specific needs.

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