Post-Abortion Complications and Menstrual Irregularities

Abortion

Hello, Doctor: I have a question to ask you.
I became pregnant for over two months at the end of February this year, but during a prenatal check-up, it was discovered that the fetus had stopped developing.
I underwent a surgical abortion in early March.
A few days after the procedure, the doctor informed me that my uterus was not contracting well and that there were many blood clots inside the uterus that could not be expelled.
I underwent treatment for nearly a month, including two additional procedures to clear the blood clots, one of which was done in an outpatient setting, before the clots were completely removed.
However, since the abortion, I have not had my menstrual cycle.
In late April, I visited a gynecologist who said everything was normal and that I was not pregnant.
The doctor mentioned that I have a special constitution that could cause this, but I had previously undergone an abortion without such issues.
An ultrasound showed that my uterine lining had thickened, and the doctor prescribed medication for three days, stating that my period would return after finishing the medication, but it still did not come (only a little spotting occurred occasionally, lasting less than a day).
When I returned for a follow-up, the doctor said that this time, a menstrual induction injection and medication should work, but it was still ineffective.
I am very worried that there may have been an oversight during the abortion procedure, leading to my current delayed menstruation.
I am also concerned that this situation might affect my ability to conceive or cause infertility.
On May 14, I visited a doctor at Hsiuchuan Hospital in Zhushan, who did not perform a pregnancy test but listened to my concerns.
The doctor conducted a pelvic exam (transvaginal ultrasound) and said there were no abnormalities, but mentioned that the uterine lining did not look good, possibly due to the surgery.
However, they could not determine the exact reason for my missed period, only suggesting that there might be adhesions in the uterine cavity and recommending the insertion of an intrauterine device (IUD).
I do not understand why I should have an IUD since I still want to have a child.
Could you please advise me on what tests I should undergo to determine what the problem is? Additionally, the doctor at Hsiuchuan prescribed Diane-35 for me, and I would like to know what this medication is and its effects.
Is there a possibility that I could be pregnant? If I am indeed pregnant, would this medication affect the fetus? I experienced sudden abdominal pain yesterday, which has continued to some extent today, so I am hesitant to take any more medication.
Furthermore, I have a history of depression and, although I am no longer taking antidepressants, I have been using STILNOX or Stimin for insomnia (as prescribed by different doctors).
Could you please tell me if these medications would have any effects on someone who is pregnant? The doctor who prescribed Stimin mentioned that it is the only sleeping medication safe for pregnant individuals; is that true? Also, could you clarify if Stimin and STILNOX are the same medication? I apologize for writing so much and taking up your time, but I am genuinely worried and confused about what to do now.
I hope to receive a prompt response so that I can understand the correct course of action to resolve my concerns.
Thank you!

vivi, 30~39 year old female. Ask Date: 2004/05/17

Dr. Zhan Deqin reply Obstetrics and Gynecology

Based on your description, it seems to be caused by adhesions of the uterine lining.
A temporary intrauterine device (IUD) can be placed to help keep the uterine lining from adhering again.
Diane is a hormonal medication that contains progestin and estrogen, used for regulating menstrual cycles, and should not be used by pregnant women.
Stinox and Stimin are the same medication, and it is best to avoid them if pregnancy is suspected.

Reply Date: 2004/05/17

More Info

I'm sorry to hear about your recent experiences and the challenges you're facing after your abortion. It's understandable to have concerns about your health, menstrual irregularities, and future fertility. Let's address your questions and provide some clarity on the situation.

Firstly, after an abortion, it is not uncommon for women to experience irregular menstrual cycles. The body undergoes significant hormonal changes during pregnancy, and it can take some time for your menstrual cycle to return to its normal rhythm. In your case, since you experienced complications such as retained blood clots and required additional procedures to clear them, this could have further delayed the return of your menstrual cycle. The thickening of the uterine lining noted on ultrasound may also be a response to hormonal changes or retained tissue.

Regarding your concern about whether the abortion procedure was mishandled, it's important to trust your healthcare provider's assessments. If they have conducted thorough examinations and ruled out any immediate complications, it is likely that your body is simply taking longer to recover than expected. However, if you continue to have concerns, seeking a second opinion from another gynecologist may provide additional reassurance.

The suggestion to consider an intrauterine device (IUD) may seem confusing, especially if you're planning to conceive again. IUDs can be used for various reasons, including regulating menstrual cycles and preventing pregnancy. However, if your goal is to become pregnant soon, you should discuss this further with your doctor to clarify the rationale behind their recommendation.

As for the medication Diane-35, it is a combination of estrogen and progestin, primarily used for treating hormonal imbalances, acne, and conditions like polycystic ovary syndrome (PCOS). It can help regulate your menstrual cycle, but it is essential to discuss with your doctor whether this is the right choice for you, especially considering your desire to conceive.

Regarding your concerns about the medications Stilnox (Zolpidem) and Stimin, both are sedative medications used to treat insomnia. While Stimin is sometimes considered safer for use during pregnancy, it is crucial to consult with your healthcare provider about any medications you are taking, especially if you are trying to conceive or suspect you might be pregnant. There is limited data on the safety of these medications during pregnancy, and your doctor can help you weigh the risks and benefits.

If you are experiencing abdominal pain, it is essential to seek medical attention promptly. Pain can be a sign of various conditions, and it is best to have it evaluated by a healthcare professional.

In summary, your concerns about menstrual irregularities and potential impacts on future pregnancies are valid. It is essential to maintain open communication with your healthcare providers, seek second opinions if necessary, and ensure that any medications you are taking are safe for your current situation. Your health and well-being are paramount, and addressing these issues with your doctor will help you find the best path forward.

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