Should You Stop Taking Menstrual Induction Medication If Flow Is Light?

If you suspect that your period has started but the flow is light on the first day after taking a menstrual induction medication, you should not stop the medication without consulting your healthcare provider. It's important to follow their guidance regarding the medication and any potential side effects or changes in your menstrual cycle?

Hello Dr.
Tsao: Due to polycystic ovary syndrome, my last menstrual period was on December 24, 2022 (I started taking Janumet from day 5 to day 21).
I did not have a menstrual period in January 2023 (during this time, there was no sexual activity and I did not take Janumet).
On February 15, 2023, I visited a gynecologist, who prescribed me a 5-day course of medication to induce menstruation (Janumet, two tablets in the morning and two in the evening, and Estrogen, one tablet in the morning and one in the evening).
I took the first dose on the evening of February 15, and after taking the morning dose on February 16, I experienced a small amount of red menstrual bleeding in the afternoon.
I continued taking the medication as prescribed on the evening of February 16 and the morning of February 17.
Typically, the flow should increase on the second day of menstruation, but the bleeding is still very light.
Should I stop taking the medication, or should I continue to complete the 5-day course? Thank you.

Xia Ri Wei Feng, 40~49 year old female. Ask Date: 2023/02/17

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, stop taking the menstrual induction medication and start taking birth control pills on the fifth day of your period.
Wishing you good health.

Reply Date: 2023/02/17

More Info

When it comes to menstrual induction medications, particularly in the context of polycystic ovary syndrome (PCOS), it is essential to understand how these medications work and what to expect regarding menstrual flow. In your case, you have been prescribed a combination of medications, including "健喬信元" (likely a form of progestin) and "生達伊使蒙" (possibly a form of estrogen or another hormonal agent), to induce menstruation after a period of amenorrhea (absence of menstruation).

The primary purpose of these medications is to mimic the natural hormonal fluctuations that occur in a typical menstrual cycle. They are designed to stimulate the uterine lining and trigger a withdrawal bleed, which is similar to a menstrual period. It is not uncommon for the initial bleeding to be light, especially when starting hormonal treatments. This can be due to several factors, including the body's response to the medication, the underlying hormonal imbalance associated with PCOS, and the timing of the medication relative to your cycle.

In your situation, you experienced light bleeding shortly after starting the medication, which is a positive sign that the medication is having an effect. However, it is also normal for the flow to be lighter than expected, particularly in the first few days. The flow may increase as the treatment continues, but this is not guaranteed.
Regarding whether to continue or stop the medication, it is generally advisable to complete the prescribed course unless otherwise directed by your healthcare provider. Stopping the medication prematurely may not allow your body to respond fully to the treatment, and you might miss the opportunity to induce a more substantial menstrual flow.
It is also important to consider that hormonal treatments can take time to regulate the menstrual cycle, especially in individuals with PCOS, where hormonal imbalances are prevalent. If you stop the medication now, you may not achieve the desired outcome of inducing a menstrual period, and it could lead to further irregularities in your cycle.

However, if you experience any concerning symptoms, such as severe cramping, heavy bleeding, or any other unusual side effects, you should contact your healthcare provider immediately. They can provide guidance based on your specific situation and may adjust your treatment plan if necessary.

In summary, unless you have specific instructions from your healthcare provider to stop the medication, it is generally recommended to continue taking it as prescribed for the full duration of the treatment. Monitor your symptoms and menstrual flow closely, and follow up with your healthcare provider if you have any concerns or if your symptoms do not improve. Regular communication with your healthcare provider is crucial in managing conditions like PCOS and ensuring that your treatment plan is effective and safe.

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