Irregular Periods: Causes, Treatments, and When to Seek Help

Irregular menstrual cycle

Hello Dr.
Lu,
I would like to ask about my recent menstrual cycle.
My last period started on December 23, and I had sexual intercourse with my husband on December 31, using the withdrawal method.
By February 14, when my period still hadn't arrived, I took traditional Chinese medicine to induce menstruation.
However, my appetite has been poor lately.
On February 19, due to nausea and vomiting, I consulted a Western medicine obstetrician-gynecologist, who performed an ultrasound and a pregnancy test, and administered an injection to induce menstruation.
The doctor told me that I would get my period within a week, but it still hasn't arrived, and my lower abdomen feels larger than before.
I'm unsure if the delayed menstruation is due to this or if I might be pregnant.
My daily routine has remained the same, and I've gained some weight, so I'm currently eating only two meals a day.
Could this reduced food intake be related to my irregular menstrual cycle? Is it possible that the ultrasound and pregnancy test results could be inaccurate? How long does it typically take for menstruation to occur after receiving the injection? Should I continue to wait, or should I seek further evaluation at a larger hospital? I apologize for taking up your valuable time, and thank you very much!

Annie, 20~29 year old female. Ask Date: 2004/03/01

Dr. Lü Lizheng reply Obstetrics and Gynecology

Hello! Ultrasound and pregnancy tests can sometimes yield inaccurate results; it is possible to be pregnant for a short time and not have it detected yet.
However, since your last menstrual period was on December 23, it has been quite a while, and it is more likely that you are experiencing irregular menstruation.
You may consider visiting another major hospital for further examination.
Sincerely, Dr.
Lu Li-Cheng, Department of Obstetrics and Gynecology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2004/03/01

More Info

Irregular periods can be a source of concern for many women, and understanding the underlying causes, potential treatments, and when to seek medical help is essential for maintaining reproductive health. Based on the information provided, it appears that you have experienced a delay in your menstrual cycle, which can be attributed to various factors.

Causes of Irregular Periods
1. Hormonal Imbalances: The menstrual cycle is regulated by hormones, and any disruption in hormone levels can lead to irregularities. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or other endocrine issues can affect hormone production.

2. Stress and Lifestyle Changes: Emotional stress, significant lifestyle changes, or alterations in diet and exercise can impact menstrual regularity. You mentioned a decrease in appetite and changes in eating habits, which can also contribute to hormonal fluctuations.

3. Pregnancy: Given that you had unprotected intercourse, even with withdrawal, there is a possibility of pregnancy. Home pregnancy tests and ultrasounds are generally reliable, but false negatives can occur, especially if taken too early.

4. Medical Conditions: Other medical conditions, such as uterine fibroids, endometriosis, or pelvic inflammatory disease, can also lead to irregular periods.

Treatments for Irregular Periods
1. Lifestyle Modifications: Maintaining a balanced diet, managing stress, and regular exercise can help regulate menstrual cycles. If you are experiencing weight gain, addressing dietary habits may also be beneficial.

2. Medications: Hormonal treatments, such as birth control pills, can help regulate periods. If you are experiencing significant discomfort or other symptoms, your healthcare provider may recommend specific medications.

3. Alternative Therapies: You mentioned taking traditional Chinese medicine (TCM) to induce menstruation. While some women find relief with TCM, it’s essential to consult with a healthcare provider to ensure that any treatment is safe and appropriate for your situation.

When to Seek Help
1. Persistent Symptoms: If your period does not return within a reasonable timeframe after receiving treatment (like the injection you mentioned), or if you continue to experience symptoms such as abdominal swelling or discomfort, it is advisable to seek further evaluation.

2. Pregnancy Concerns: If there is a possibility of pregnancy, it is crucial to confirm this with a healthcare provider. If you suspect you might be pregnant, a blood test can provide more accurate results than a home pregnancy test.

3. Severe Symptoms: If you experience severe abdominal pain, heavy bleeding, or other concerning symptoms, you should seek immediate medical attention.

Conclusion
In summary, irregular periods can result from various factors, including hormonal imbalances, lifestyle changes, and potential pregnancy. It is essential to monitor your symptoms and consult with a healthcare provider if your menstrual cycle does not normalize or if you have concerns about pregnancy. Given your situation, it may be beneficial to follow up with a gynecologist for a comprehensive evaluation and to discuss further management options. Your health and well-being are paramount, and seeking professional advice is the best course of action.

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