Delayed Menstruation After Hormonal Induction: Key Insights

Menstruation did not occur after taking menstrual induction medication?

Hello doctor, my sexual partner has always had regular 28-day cycles, but suddenly the last two cycles were 22 days.
The last menstrual period was from December 20 to December 25.
I had sexual intercourse on January 2 and January 12, initially without a condom, and used a condom during the later part of the cycle.
According to the regular 28-day cycle, my period was expected on January 16, but it did not come.
I took a home pregnancy test on January 17, which was negative, and then went to the obstetrics and gynecology department for a urine test on January 18, which was also negative.
The ultrasound showed normal results, and the doctor did not mention anything specific.
Later, I received an injection to induce menstruation, but as of January 22, my period still had not arrived.
I used a pregnancy test again, which was still negative.
As of today, January 26, my period is over 10 days late, and it has been more than 7 days since the injection.
I would like to ask: 1.
Were the pregnancy tests on January 17, 18, and 22 effective? 2.
Since receiving the injection, I have experienced dull pain in my lower abdomen, which has persisted and comes in intermittent waves; is this normal? 3.
If I return for a follow-up and the pregnancy test is negative but my period is about to start, will another injection to induce menstruation cause further delays in my cycle?

Niming, 20~29 year old female. Ask Date: 2023/01/26

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it seems that you are not pregnant.
Normally, you should get your period within a week after receiving an injection or taking medication.
Since it has been a bit longer, I recommend seeing a gynecologist.
Wishing you good health.

Reply Date: 2023/01/26

More Info

Delayed menstruation can be a complex issue, especially after hormonal induction. It’s important to understand the various factors that can contribute to this situation, particularly in the context of your recent experiences.

1. Validity of Pregnancy Tests: The pregnancy tests you conducted on January 17, January 18, and January 22 are generally considered effective if they were performed correctly and at the right time. Home pregnancy tests are most reliable when taken after a missed period, which in your case would be after January 16, given your usual cycle. However, since you had sexual intercourse on January 2 and January 12, it is possible that implantation could have occurred, but if the tests were negative, it is likely that you are not pregnant. Urine tests conducted in a clinical setting are also reliable, and since those were negative, it further supports the conclusion that pregnancy is unlikely.

2. Post-Injection Symptoms: The discomfort you are experiencing in your lower abdomen after receiving the hormonal injection (likely a progestin) can be a normal side effect. Hormonal treatments can cause various symptoms, including cramping, bloating, and changes in menstrual patterns. The intermittent pain you describe could be related to the hormonal changes induced by the injection. However, if the pain becomes severe or is accompanied by other concerning symptoms (such as heavy bleeding, fever, or unusual discharge), it would be prudent to seek medical attention.

3. Impact of Additional Hormonal Induction: If you return for a follow-up and the pregnancy test remains negative, administering another dose of the hormonal injection could potentially affect your menstrual cycle further. Hormonal treatments can sometimes lead to irregular cycles, and repeated doses may prolong the delay in menstruation rather than induce it. It is essential to discuss your symptoms and concerns with your healthcare provider, who can offer personalized advice based on your medical history and current situation.

In summary, it is not uncommon for hormonal treatments to cause delays in menstruation, and the symptoms you are experiencing may be related to the hormonal changes in your body. If your period does not arrive soon, or if you continue to experience discomfort, it is advisable to consult with your healthcare provider for further evaluation and management. They may consider additional tests or alternative treatments to help regulate your cycle and address any underlying issues.

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