Menstrual Changes After Induction: Key Questions Answered

Q: Menstrual Changes After Induction: Key Questions Answered

Dear Xiao Zi：<br>1. <br>Is it possible not to see the fetus on an abdominal ultrasound at three or four months of pregnancy? <br>Answer： Under normal circumstances, the fetus should be large enough to be visible by this time. <br>Unless in very rare cases, where the menstrual cy

Menstruation has started after taking menstrual induction medication?

Hello Doctor: I would like to ask the following questions:
1.
Is it possible to be three or four months pregnant and not see the fetus on an abdominal ultrasound? If the doctor quickly concludes that the uterus is normal and there are no issues, is there a possibility that they overlooked something due to not examining thoroughly?
2.
After receiving a menstrual induction injection and taking menstrual induction medication (the doctor prescribed contraceptive pills), if I experience bleeding similar to a menstrual period, can I confirm that it is indeed a true menstrual period? Is there a possibility that the bleeding after induction is not a true menstrual period but rather implantation bleeding from a pregnancy?
3.
The doctor prescribed Winstrol (Winstop) for one month to regulate my menstrual cycle.
After completing the 21-day course, can I confirm that the bleeding I experience is a true menstrual period and that I am not pregnant? Does this type of contraceptive pill contain progesterone, which could raise my basal body temperature and maintain it at a higher level?
4.
Before the menstrual induction, my basal body temperature was around 36.2 to 36.3 degrees Celsius.
After the injection, it rose to 36.5 to 36.6 degrees.
A week later, since my period still hadn't arrived, I started taking medication for induction, and my temperature rose again to between 36.7 and 37 degrees.
However, after my period started, my temperature only dropped to between 36.6 and 36.4 degrees.
Why did it not return to the lower temperature? Thank you, Doctor.

Xiao Zi, 20~29 year old female. Ask Date: 2012/05/10

Dr. Lü Lizheng reply Obstetrics and Gynecology

Dear Xiao Zi:
1.
Is it possible not to see the fetus on an abdominal ultrasound at three or four months of pregnancy?
Answer: Under normal circumstances, the fetus should be large enough to be visible by this time.
Unless in very rare cases, where the menstrual cycle has become irregular, one might mistakenly believe they are three or four months pregnant when they have only just conceived, which could result in the fetus not being visible on an abdominal ultrasound.
2.
If I experience bleeding similar to menstruation after receiving a menstrual induction injection and taking menstrual induction medication (prescribed birth control pills), can I confirm that it is indeed a true menstrual period? Is there a possibility that the bleeding after induction is not a true menstrual period but rather implantation bleeding?
Answer: If a pregnancy has already occurred, there will be no menstrual period even after receiving a menstrual induction injection or taking menstrual induction medication.
Early pregnancy bleeding can sometimes be mistaken for menstruation, but the timing is usually not that coincidental.
3.
After taking prescribed by my doctor for one month to regulate my menstrual cycle, can I confirm that the bleeding I experience after completing the 21-day course is a true menstrual period and that I am not pregnant? Does this type of birth control pill contain progesterone, which would raise my basal body temperature and keep it elevated?
Answer: The bleeding after taking the medication is not indicative of pregnancy.
Progesterone can cause a slight increase in body temperature.
4.
My basal body temperature was around 36.2 to 36.3 degrees Celsius before the menstrual induction.
After receiving the injection, it rose to 36.5 to 36.6 degrees.
A week later, since menstruation still hadn't occurred, I started taking medication to induce menstruation, and my temperature rose again to between 36.7 and 37 degrees.
However, after menstruation began, my temperature only dropped to between 36.6 and 36.4 degrees.
Why didn't it return to the lower temperature?
Answer: Besides progesterone, which can elevate body temperature, other factors such as having a cold, being ill, increased physical activity, and accelerated metabolism can also cause a rise in body temperature.
Wishing you peace and health,
Director of Obstetrics and Gynecology, Taoyuan Hospital, Department of Health,
Lu Li-Zheng

Reply Date: 2012/05/10

More Info

Understanding menstrual changes after induction, especially in the context of potential pregnancy and hormonal treatments, can be complex. Let’s address your questions one by one.

1. Ultrasound Visibility of the Fetus: It is indeed possible for an ultrasound performed at three or four months of pregnancy to not show a fetus, although this is relatively uncommon. Factors such as the position of the fetus, the quality of the ultrasound equipment, and the skill of the technician can all play a role. If the doctor quickly assessed the ultrasound and stated that the uterus appeared normal, it is possible that they may have missed something, but this is unlikely if they are experienced. If there are concerns about the pregnancy, it may be advisable to seek a second opinion or request a follow-up ultrasound.

2. Bleeding After Induction: When you receive medication to induce menstruation, such as hormonal treatments or contraceptives, the bleeding that follows can often be considered a withdrawal bleed rather than a true menstrual period. However, if you are concerned about the possibility of pregnancy, it is important to take a pregnancy test. Induction medications can sometimes cause bleeding that mimics a menstrual period, but it does not necessarily confirm that you are not pregnant. If there is any doubt, consulting with your healthcare provider is essential.

3. Confirming Menstrual Cycle with Winstrol: Winstrol (stanozolol) is an anabolic steroid and is not typically used for menstrual regulation. If you were prescribed a hormonal contraceptive to regulate your cycle, the bleeding that occurs after completing the 21-day course can be considered a withdrawal bleed. However, it is important to confirm with a pregnancy test if you suspect pregnancy. Hormonal contraceptives can contain progestins, which may elevate your basal body temperature, but they do not guarantee that your cycle will return to its previous state immediately after stopping the medication.

4. Basal Body Temperature Changes: The basal body temperature (BBT) can fluctuate due to various factors, including hormonal changes induced by medications. After taking induction medication, it is common for BBT to rise due to the effects of progesterone. If your temperature remains elevated even after menstruation begins, it could be due to residual hormonal effects or other factors. It is not unusual for BBT to not drop back to pre-ovulatory levels immediately after menstruation starts, especially if hormonal treatments are involved.

In summary, if you have concerns about your menstrual cycle, potential pregnancy, or the effects of medications, it is crucial to maintain open communication with your healthcare provider. They can provide personalized advice based on your medical history and current situation. Regular follow-ups and monitoring can help ensure that any issues are addressed promptly and effectively.

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