Irregular Menstrual Cycles: Causes and Concerns - Obstetrics and Gynecology

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Irregular menstrual cycles can be a source of concern for many women, and understanding the underlying causes is crucial for addressing any potential health issues. In your case, the absence of menstruation for several months, along with the history of a very light period in February and the use of emergency contraception, raises several important points to consider.

Firstly, it is essential to recognize that hormonal fluctuations are a common cause of irregular menstrual cycles. The menstrual cycle is regulated by a complex interplay of hormones, including estrogen and progesterone. When these hormones are disrupted, it can lead to irregularities in the cycle. The use of emergency contraception, such as the morning-after pill, can temporarily alter hormone levels, potentially leading to changes in your menstrual cycle. It is not uncommon for women to experience lighter periods or delayed cycles after taking such medication.

Additionally, your history of ovarian cysts (referred to as "水瘤" in your message) may also contribute to menstrual irregularities. Ovarian cysts can affect hormone production and disrupt the normal functioning of the ovaries, leading to changes in the menstrual cycle. While your recent ultrasound did not show any abnormalities, it is still possible that hormonal imbalances related to previous cysts could be influencing your current situation.

The symptoms you describe, such as breast tenderness (indicated by "漲奶") and abdominal pain (particularly on the left side), may also be linked to hormonal fluctuations. Breast tenderness is often associated with changes in estrogen and progesterone levels, while abdominal pain can be a sign of various conditions, including ovulation pain or other gynecological issues.

Given that you have consulted two doctors and have been prescribed medications to induce menstruation without success, it may be beneficial to explore further diagnostic options. Some potential causes of amenorrhea (the absence of menstruation) include:
1. Polycystic Ovary Syndrome (PCOS): This condition is characterized by hormonal imbalances and can lead to irregular periods, weight gain, and other symptoms.

2. Thyroid Disorders: Both hyperthyroidism and hypothyroidism can affect menstrual cycles. Thyroid function tests can help determine if this is a contributing factor.

3. Stress and Lifestyle Factors: High levels of stress, significant weight changes, or excessive exercise can impact hormone levels and menstrual regularity.

4. Chronic Conditions: Conditions such as diabetes or certain autoimmune disorders can also affect menstrual cycles.

5. Pregnancy: Although you mentioned the use of emergency contraception, it is still important to rule out pregnancy, as some women may experience irregular bleeding or other symptoms.

In summary, while the use of emergency contraception may have contributed to your irregular cycles, it is essential to consider other potential factors, including hormonal imbalances, previous ovarian cysts, and lifestyle influences. If your symptoms persist or worsen, it may be advisable to seek further evaluation from a gynecologist or an endocrinologist who specializes in hormonal disorders. They may recommend additional tests, such as blood tests to check hormone levels or imaging studies, to gain a clearer understanding of your condition and guide appropriate treatment options.