Menstrual Irregularities: Causes and Solutions

Menstruation has not occurred?

Hello, Doctor.
I had a normal menstrual period on March 15.
I had intercourse on April 14-15, and then my period was delayed by 10-11 days, arriving on April 26 (I took over-the-counter medication to induce menstruation, Metrone).
It ended on May 2, and then my period came again on May 24 and ended on the 30th.
However, I did not have a period at all in June.
I had intercourse around the 20th but used protection.
My period still hasn’t arrived, so I bought more medication to induce menstruation and have been taking it for five days.
Now it’s July 3, and my period still hasn’t come.
I’m really a bit anxious.
What could be the situation, Doctor? 🥲

Miss Wang, 10~19 year old female. Ask Date: 2022/07/03

Dr. Huang Zifei reply Obstetrics and Gynecology

Dear Ms.
Wang,
Please visit the obstetrics and gynecology department for a pregnancy test, as we need to confirm whether you are pregnant before proceeding with the next steps.

Dr.
Huang Zifei, Obstetrics and Gynecology Department, Nantou Hospital

Reply Date: 2022/07/03

More Info

Menstrual irregularities can be a source of concern for many women, and understanding the underlying causes is essential for finding appropriate solutions. Based on your description, it appears that you have experienced a series of irregular menstrual cycles, including delayed periods and the use of medication to induce menstruation. Let's explore some potential causes and solutions for your situation.

Causes of Menstrual Irregularities
1. Hormonal Imbalances: The menstrual cycle is regulated by a complex interplay of hormones, including estrogen and progesterone. Any disruption in this hormonal balance can lead to irregularities. Factors such as stress, significant weight changes, or underlying medical conditions can contribute to hormonal imbalances.

2. Ovulatory Issues: Anovulation, or the failure to ovulate, can lead to missed or irregular periods. Conditions like polycystic ovary syndrome (PCOS) are common causes of anovulation and can result in irregular cycles.

3. Stress and Lifestyle Factors: High levels of stress, changes in routine, or lifestyle factors such as excessive exercise or poor diet can impact your menstrual cycle. Stress can affect the hypothalamus, which plays a crucial role in regulating the menstrual cycle.

4. Medications: The use of medications, such as the ones you mentioned (e.g., menstrual induction pills), can also affect your cycle. While these medications can help induce menstruation, they may not address the underlying cause of the irregularity.

5. Pregnancy: Although you mentioned using protection during intercourse, it's important to consider the possibility of pregnancy, as contraceptive methods are not 100% effective. A missed period is often one of the first signs of pregnancy.

6. Underlying Health Conditions: Conditions such as thyroid disorders, diabetes, or other endocrine issues can also lead to menstrual irregularities. It's essential to rule out these conditions through appropriate testing.

Solutions and Recommendations
1. Consult a Healthcare Provider: Given the complexity of menstrual irregularities, it is crucial to consult with a healthcare provider. They can perform a thorough evaluation, including a physical examination, blood tests to check hormone levels, and possibly imaging studies to assess your reproductive organs.

2. Track Your Cycle: Keeping a detailed record of your menstrual cycle, including the dates, flow, and any symptoms you experience, can provide valuable information to your healthcare provider. This information can help identify patterns and potential triggers for your irregularities.

3. Lifestyle Modifications: Consider making lifestyle changes that promote hormonal balance. This includes managing stress through relaxation techniques, maintaining a healthy diet, and engaging in regular physical activity. Avoiding excessive exercise and ensuring adequate nutrition can also be beneficial.

4. Medication Review: If you are taking medications to induce menstruation frequently, discuss this with your healthcare provider. They can help determine whether this is the best approach for your situation or if alternative treatments are needed.

5. Consider Pregnancy Testing: If there is any chance of pregnancy, it would be wise to take a home pregnancy test. If the test is negative and your period still does not arrive, follow up with your healthcare provider for further evaluation.

6. Explore Treatment Options: Depending on the underlying cause of your menstrual irregularities, your healthcare provider may recommend specific treatments. This could include hormonal therapies, lifestyle changes, or management of any underlying health conditions.

In summary, menstrual irregularities can stem from various factors, including hormonal imbalances, stress, lifestyle changes, and underlying health conditions. It is essential to seek medical advice to identify the root cause and explore appropriate treatment options. Remember, you are not alone in this, and with the right support, you can find a solution that works for you.

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