Should You Continue Taking Menstrual Induction Medication?

If your menstrual period has started, there is no need to take medication to induce menstruation?

Hello, Doctor.
Since the first day of my last menstrual period, it has been nearly 80 days without menstruation.
I visited a doctor who informed me that my endometrium is very thin, so I was prescribed a course of medication (11 days of estrogen followed by 11 days of estrogen and progesterone) with the assurance that my period would start after completing the course.
However, on the 7th day of taking estrogen, I began to bleed, and the bleeding has been quite heavy, resembling a menstrual period.
I consulted the doctor about whether I should continue taking the medication, and the doctor advised me to finish the course.
However, I have been bleeding for 13 days now (the amount has gradually decreased, but the blood is still red).
I would like to ask: 1.
Should I continue taking the medication? 2.
Should I schedule a follow-up appointment soon? I have always had regular menstrual cycles and have never experienced this situation before, so I am feeling a bit anxious.
Thank you very much for your response.

Han, 20~29 year old female. Ask Date: 2024/01/09

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Please take the medication as prescribed.
If you have any concerns, please return for a consultation.
Thank you.

Reply Date: 2024/01/09

More Info

When it comes to the use of menstrual induction medication, it is essential to consider both the medical context and the individual patient's response to treatment. Based on your situation, where you have been prescribed estrogen and progesterone to induce menstruation after a prolonged absence of your period, there are a few key points to address.

1. Continuation of Medication: Since you have already started the medication and are experiencing bleeding, it is generally advisable to complete the course as prescribed by your doctor. The bleeding you are experiencing could be a response to the hormonal changes induced by the medication. It is not uncommon for patients to experience breakthrough bleeding or prolonged bleeding when starting hormonal treatments. However, since you are already on day 13 of bleeding, it is crucial to monitor the situation closely. If the bleeding becomes excessively heavy (soaking through a pad every hour), or if you experience severe pain, dizziness, or any other concerning symptoms, you should seek medical attention immediately.

2. Follow-Up Appointment: Given that you have a history of regular menstrual cycles and are now experiencing an unusual pattern of prolonged bleeding, it is advisable to schedule a follow-up appointment with your healthcare provider. This is especially important since you mentioned feeling anxious about the situation. Your doctor can evaluate your symptoms, perform any necessary examinations, and determine if further intervention is needed. They may also want to check your hormone levels or perform an ultrasound to assess the condition of your endometrium (the lining of your uterus) and ensure that there are no underlying issues contributing to the abnormal bleeding.

In addition to these points, it is important to understand the role of hormones in menstrual regulation. Estrogen and progesterone are critical in preparing the uterine lining for a potential pregnancy. If pregnancy does not occur, the withdrawal of these hormones leads to menstruation. In your case, the thin endometrial lining may have contributed to the irregularities you are experiencing. Hormonal treatments can help thicken the lining and regulate your cycle, but they can also lead to side effects, including changes in bleeding patterns.

If you have concerns about the medication's side effects or its effectiveness, discussing these with your healthcare provider is essential. They can provide reassurance, adjust your treatment plan if necessary, and help you understand what to expect moving forward.

Lastly, it is worth noting that anxiety regarding menstrual irregularities is common, especially when they deviate from your norm. Keeping a record of your symptoms, including the duration and intensity of bleeding, can be helpful for your healthcare provider in assessing your situation. Remember, open communication with your doctor is key to managing your health effectively.

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