Delayed Menstruation After Vacuum Aspiration: What to Know

Missed menstruation?

Hello doctor, I underwent a vacuum aspiration procedure on September 6th (when the embryo was 2 weeks old).
Since the embryo was still very small, there was no bleeding when the gauze was removed three hours after the surgery, and the doctor said I didn’t need any special supplements or restrictions.
Two days later, during a follow-up appointment, I learned that I had a Candida infection, and the doctor prescribed some medication for me, which I did not find uncomfortable.
Three weeks later, I swam for half an hour without any dietary restrictions.
Since mid-September, I have been engaging in sexual intercourse, always using condoms.
On the night of October 12th, I used a pregnancy test, which came back negative, but my period has not arrived yet, and I have been experiencing intermittent lower abdominal pain since the week before last.
This week, I even felt nauseous and very sleepy (I’m not sure if it’s because of the autumn season).
I am very worried; could it be due to staying up late or related to the surgery? If I confirm that I am not pregnant, should I take medication to induce my period? How long do most women typically wait for their period to return? Thank you for your thoughtful response, and I appreciate your hard work.

Xin En, 10~19 year old female. Ask Date: 2015/10/22

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
A pregnancy test was performed, and the result was negative, which indicates that there is likely no pregnancy.

2.
Continuous abdominal cramping can have many causes; it is advisable to seek medical evaluation to determine the cause and receive appropriate treatment.

3.
After a miscarriage procedure, menstruation typically returns in about one to two months.

Respectfully, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/10/22

More Info

Delayed menstruation after a vacuum aspiration can be a concerning issue for many women, especially after experiencing a pregnancy loss. It’s important to understand the physiological changes that can occur following such a procedure and the factors that may contribute to delayed menstruation.

Firstly, vacuum aspiration is a common procedure used to terminate a pregnancy, especially in the early stages. After the procedure, it is typical for women to experience some changes in their menstrual cycle. The timing of the return of menstruation can vary significantly from one individual to another. Generally, most women can expect their menstrual cycle to return within four to six weeks after the procedure, but this can be influenced by several factors, including hormonal fluctuations, stress, and overall health.

In your case, since the procedure was performed on September 6 and you have not yet experienced your period, it is understandable to feel anxious. The absence of menstruation can be attributed to several reasons:
1. Hormonal Changes: After a pregnancy loss, your body undergoes hormonal adjustments. The levels of hormones such as estrogen and progesterone may take time to stabilize, which can delay the onset of menstruation.

2. Physical and Emotional Stress: The emotional toll of a pregnancy loss, combined with physical recovery from the procedure, can impact your menstrual cycle. Stress can lead to hormonal imbalances that may delay menstruation.

3. Infection or Complications: You mentioned having a yeast infection that was treated after the procedure. While this is typically not a direct cause of delayed menstruation, any infection or complication following a surgical procedure can affect your body’s recovery and hormonal balance.

4. Pregnancy: Although you have tested negative for pregnancy, it is essential to consider the timing of ovulation and the potential for false negatives in early pregnancy tests. If you suspect you might still be pregnant, it would be prudent to consult your healthcare provider for further evaluation.

Regarding your symptoms of abdominal pain, nausea, and fatigue, these could be related to hormonal changes, stress, or even the lingering effects of the procedure. It is not uncommon for women to experience discomfort during this time, but persistent or severe symptoms should be evaluated by a healthcare professional.

As for the question of whether to take medication to induce menstruation, it is generally advisable to consult with your healthcare provider before doing so. They can assess your individual situation, including your health history and current symptoms, to determine the best course of action. Inducing menstruation without medical supervision may not address the underlying cause of the delay and could potentially lead to complications.

In summary, while it is common for menstruation to be delayed after a vacuum aspiration, it is essential to monitor your symptoms and consult with your healthcare provider if you have concerns. They can provide guidance tailored to your specific situation and help ensure that your recovery is progressing as expected. Most women will see their menstrual cycle return within a few weeks to a couple of months, but individual experiences can vary widely.

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