Changes in Menstrual Cycle After Hormonal Treatment

Previously, the uterus was damaged by medication, resulting in changes to the menstrual cycle compared to before?

I have received two doses of progesterone, and after more than a year since the last dose, I still haven't had my period.
Why is this happening? Do I need treatment?

Wo de chenghu, 40~49 year old female. Ask Date: 2014/08/12

Dr. Lin Wenbin reply Obstetrics and Gynecology

It's hard to understand what you mean by "the uterus was harmed by medication before." The body's hormones are influenced by age, lifestyle, stress, and diet.
This impact accumulates over the years, far exceeding the effects of one or two instances of medication by hundreds or thousands of times.
You need to have a thorough discussion with your doctor.

Reply Date: 2014/08/12

More Info

Understanding changes in the menstrual cycle after hormonal treatment, particularly after receiving progesterone (often referred to as "黄体素" in Chinese), can be complex and varies significantly among individuals. Hormonal treatments can lead to various changes in menstrual patterns, and it’s essential to consider several factors that could contribute to the absence of menstruation (amenorrhea) after treatment.

Firstly, progesterone is a hormone that plays a crucial role in regulating the menstrual cycle. It is typically administered to help regulate periods, especially in cases of irregular menstruation or to support the luteal phase of the cycle. After receiving progesterone, some women may experience a withdrawal bleed, which mimics a menstrual period. However, if there has been a significant gap between treatments, as in your case, it is possible that the hormonal balance in your body has been disrupted, leading to changes in your menstrual cycle.

Several reasons could explain why you have not had a period after your recent progesterone treatment:
1. Hormonal Imbalance: The menstrual cycle is regulated by a delicate balance of hormones, including estrogen and progesterone. If there is an imbalance, it can lead to irregularities or the absence of menstruation.

2. Stress and Lifestyle Factors: Stress, significant weight changes, excessive exercise, or changes in diet can all impact hormonal levels and menstrual cycles. If you have experienced any of these changes recently, they could be contributing to your amenorrhea.

3. Underlying Medical Conditions: Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or other hormonal disorders can affect menstrual cycles. If you have a history of such conditions, they may need to be evaluated.

4. Age and Menopause: Depending on your age, it is also possible that you are approaching perimenopause, which can lead to irregular cycles and missed periods.

5. Medication Effects: If you are taking other medications or have recently changed any medications, this could also affect your menstrual cycle.

Regarding treatment, it is essential to consult with a healthcare provider to evaluate your specific situation. They may recommend:
- Hormonal Evaluation: Blood tests to check hormone levels can help determine if there is an imbalance that needs to be addressed.

- Ultrasound or Imaging: To check for any structural issues in the reproductive system that could be causing amenorrhea.

- Lifestyle Modifications: Recommendations for stress management, dietary changes, or exercise adjustments may be beneficial.

- Further Hormonal Treatment: Depending on the findings, your doctor may suggest continuing or adjusting hormonal treatments.

In conclusion, while hormonal treatments like progesterone can help regulate menstrual cycles, various factors can lead to changes or the absence of menstruation. It is crucial to seek medical advice to identify the underlying cause and determine the appropriate course of action. Regular follow-ups and open communication with your healthcare provider will be key in managing your menstrual health effectively.

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