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What Causes Delay In Menstruation After Having I-pill?

Posted on Sat, 23 Jan 2016

Question: Hi I m 25yrs old. I have a regular menstrual cycle of 28-30days. I had an I pill some 3-4months back n also an abortion a yr back. After I pill, I just had a month irregularity than everything was fine.. Now on 18th Dec we made out and my periods were due on 19th Dec, this time I do not experience any kind of PMS. N now its been 10days of missed period. What could be the reason? I had urine pregnancy test also just to confirm, n it was negative. I m also getting a doubt of pcod just because of this missed period and also because of hormones i have taken in the form of I pill n abortion pills. Can all these things cause pcod? Or am I pregnant? Please help its really confusing. Also I haven't gain weight,it is constant nor I have any other symptom of pcod like facial hair etc, its just my periods are missed

Answered by Dr. Sameer Kumar (1 hour later)

Brief Answer:
hormonal imbalance.

Detailed Answer:
Hello,
Thanks for the query to hcm,
You may get a serum beta hcg test done for conclusively deciding if you are pregnant or not first. If the test is positive, then you are pregnant and if its negative then the delay can be due to hormonal imbalance. As you had sex a day prior your menses due date , hence there is likely progesterone excess and hence menses delayed. You may wait for at least 15 days post due date to allow menses resume naturally if pregnancy is ruled out.
If still menses are not resumed then you may opt for a withdrawal bleed with progesterones.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sameer Kumar (20 minutes later)

Since my urine pregnancy test is negative, still I have to do serum hcg? I think UPT also detects the same hormone. N I want to tell u that I have done my thyroid profile, it was normal, except that my TSH was on border I.e. 5.50, is it a reason to worry? N today I experienced white discharge instead of period for the first time after this delay

Answered by Dr. Sameer Kumar (2 hours later)

Brief Answer:
answered

Detailed Answer:
Hello,
Urine pregnancy test is to be done after 8 days post missed periods so if you have done it today or yesterday then its conclusive else it may be a false negative. Hence i advised for serum beta hcg. Once that comes negative you can be doubly sure and then the cause can be related to hormonal imbalance.
BorderlineTSH is acceptable and shouldn't be the cause of delay in your case its mor likely stress related.
Secondly if its PCOS, then a complete hormonal profile and ultrasound pelvis would be required to check if there are multiple follicles in the ovary and if your androgen levels are high. But a single episode with previous regular menses doesn't actually qualify for PCOS.
Hence suggested that if the menses are not resumed in another week then you may opt for a withdrawal bleed with progesterones if hcg test is negative .
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sameer Kumar (2 days later)

Hello I did UPT today and it was negative, periods have not started till now. Do I need to do some other health check ups or need to wait for another cycle. Also suggest the name of the medicine that can b taken to start the menses both in quantity and timings

Also I need a suggestion on my thyroid level.. It was on the borderline 5.50, is there any chances of development of hypothyroidism?? What can b done to prevent this? I guess medications are not recommended at this level??? What should b the next step?

Answered by Dr. Sameer Kumar (45 hours later)

Brief Answer:
you are not pregnant...

Detailed Answer:
Hello,
As UPT is negative , that implies tag you are not pregnant for sure now. Hence you should ideally wait for a total of 115 days post missed periods to allow menses to start naturally and if hey don't then you can opt for a withdrawal bleed with progesterones. In that case you have to take TAB PRIMOLUT-N 5mg twice a dau=y for next 5 days and your withdrawal bleeding should start within 5-7 days from the date of last dosage.
TSH level of 5.5 is still acceptable and doesn't qualify for hypothyroidism treatment presently. You may repeat the test after 1 month again and the treatment if required can be decided upon.
Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar