Delayed Menstruation: Causes and Medical Responses

Inquiring about the reasons for a delayed menstrual period and the physician's approach to management?

Hello, Doctor: My last menstrual period was from July 23 to July 26, and I have not had my period since then.
During this time, I had unprotected intercourse without ejaculation on August 15, 16, 22, 29, and 30.
From August 1 to August 14, I was hospitalized due to a urinary tract infection and was on medication, including antibiotics.
After a follow-up on August 28, I was prescribed oral antibiotics and stomach medication until that date.
During the follow-up, I asked the doctor if the medication could be the reason for my delayed period, but the response was vague, stating "it shouldn't be the case." On August 31, I consulted a gynecologist, and after a urine test, it was confirmed that I am not pregnant.
The gynecologist advised that if my period does not arrive in two weeks, I should return for another check-up.
If my period still hasn't come by next week, what could be the possible reasons? Is there still a possibility of pregnancy? Additionally, what kind of management might the doctor consider?

Tiao Tiao, 20~29 year old female. Ask Date: 2015/09/04

Dr. Lü Lizheng reply Obstetrics and Gynecology

Hospitalization due to illness can be a form of stress.
In a tense and stressful environment, a woman's ovarian function may weaken, leading to hormonal instability and menstrual irregularities, which can result in a delayed period.
Due to the decreased likelihood of ovulation, the chances of pregnancy are low.
However, since the last sexual intercourse was on August 31, it is advisable to wait until at least mid-September to perform a urine test to confirm whether pregnancy has occurred.
If menstruation continues to be delayed, physicians typically prescribe menstrual regulation medications or administer hormonal injections to induce menstruation.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/09/04

More Info

Understanding delayed menstruation can be a complex issue, as it can arise from various factors, including hormonal imbalances, stress, medical conditions, and medication side effects. In your case, you have provided a timeline of your menstrual cycle, sexual activity, and medical history, which is essential for understanding your situation better.

Firstly, your last menstrual period was from July 23 to July 26, and you have not experienced menstruation since then. You mentioned engaging in unprotected sexual intercourse on several occasions in August, which raises the question of potential pregnancy. However, you have already undergone a urine pregnancy test that returned negative, which is a good initial step in ruling out pregnancy.

The medications you mentioned, including antibiotics and other treatments for your urinary tract infection (UTI), can sometimes affect your menstrual cycle. While your doctor suggested that the medications should not cause significant delays in your menstruation, it is important to note that individual responses to medications can vary. Stress, whether physical or emotional, can also play a significant role in delaying menstruation. The stress of being hospitalized and dealing with a UTI may have contributed to your current situation.

If your period does not arrive within the next week, there are several potential causes to consider:
1. Hormonal Imbalances: Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can lead to irregular menstrual cycles. Hormonal fluctuations can be triggered by various factors, including stress, weight changes, and medical conditions.

2. Pregnancy: Although you have tested negative for pregnancy, it is worth noting that some tests may not detect pregnancy in very early stages. If your period does not arrive, it may be advisable to repeat the pregnancy test or consult your healthcare provider for a blood test, which is more sensitive.

3. Lifestyle Factors: Significant changes in weight, exercise habits, or stress levels can impact your menstrual cycle. If you have experienced any of these changes recently, they could be contributing to your delayed menstruation.

4. Medical Conditions: Other underlying medical conditions, such as endometriosis or uterine fibroids, can also affect your menstrual cycle. If your period does not return, further evaluation may be necessary.

In terms of medical responses, if your period does not arrive within the next two weeks, it is advisable to follow up with your gynecologist. They may perform additional tests, such as blood tests to check hormone levels, or conduct a pelvic exam to assess for any underlying conditions. Depending on the findings, treatment options may include hormonal therapy, lifestyle modifications, or addressing any underlying medical issues.

In summary, while there are several potential causes for your delayed menstruation, it is essential to monitor your symptoms and follow up with your healthcare provider if your period does not return. They can provide a more accurate diagnosis and appropriate treatment options based on your individual situation. Remember that open communication with your healthcare provider is crucial in addressing your concerns and ensuring your reproductive health is managed effectively.

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