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Had Intercourse. Took Ipill. Missing Periods. Advised To Take Premarin. What Should I Do?

Posted on Tue, 16 Oct 2012

Question: Hello Dr. XXXXXX

I have taken an advice from you, below is the history. My question is that I have not got my periods yet. what do i do?

History
I had my periods from 2nd july 2012 and lasted till 6th july 2012, I had sex on 6th and took an ipill within 5 hours, I consumed another ipill on 7th July as a precaution.

I had seen a Gynae and was not convinced. I had got two Beta HCG done, both negative, latest on 25th August 2012. I have also done urine pregnancy test which have also come negative.I was advised to take meprate 10 mg for ten days and I took it from 9th August 2012 till 18th August 2012. from 23rd August I had mild bleeding (negligible). I waited from 19th Aug till 25th Aug however did not get my periods appropriately.Doctor advised me for an ultrasound which stated as below:
on 25th Aug 2012
Uterus is anteverted. It measures 7.6*4.8*3.8 cm. There are two, 10 mm and 12 mm subserous hypoechoic lesions in the posterior myometrium.Endometrial thickness = 9 mm.Cervix is normal in size with a smooth outline. Few, 5 - 10 mm follicles are seen in both.Right Ovary = 8.6cc, Left Ovary = 8cc.No adenexal lesion is seen.No fluid is seen in the pouch of XXXXXX Urinary bladder is normal.Opinion: Small, subserous fibroids in the uterus.

Beta HCG : 2 Aug 2012 - 3.6.
Pregnancy Test: Negative- 25th August 2012

I had been prescribed Premarin 0.625 1 daily for 15 days which I am taking from 25th August 2012. My bleeding had improved however it was negilgible to allow me to use Sanitary.

you had advised me to take premarin for 10 days which i took from 25th Aug till 3rd September however I have not got my periods yet.

Please suggest.

Answered by Dr. Chetna Jain (21 hours later)

Hi XXXXXX
Its unusual to have no periods even after stopping Premarin on 3.9.2012
This is worrying.
Please do Beta hCG again. If this is negative you may be put on tab Ovral G for 7 days by your doctor. Please do not take from the chemist directly. This tablet should be taken only after ensure that there is no contraindication like history of clots, cancer, migraine, liver disease etc.
If you dont bleed after 7 days of stopping Ovral G then its better to do blood FSH levels.
Should you have any more queries please let me know.
All the best.

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

Follow up: Dr. Chetna Jain (6 hours later)

Thanks for the response doctor. Should I rather take an appointment with you in columbia-asia so that you can prescribe these tests for me?
I do have migraine which has been recently detected. I had tenderness in my breast the last two weeks however it has reduced now. i also have increased white discharge (more thread like).
how much time does it take to get periods post premarin? I would complete 3 weeks post premarin on 24th Sep.
Could you suggest a best day and time to visit you in the hospital?

Does this mean high cause of worry?

regards XXXXXX

Answered by Dr. Chetna Jain (14 hours later)

Hi XXXXXX

Normally the periods start in about 3-7 days after stopping the medication.
We must look at it seriously now.

It may or may not have long term repercussions and to find out that we need to do some tests.

If you want to see me you can book an appointment at Columbia Asia Hospital 0124-0000 or you may call up my PA XXXXXX@ 0000 if all the appointments are full.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Chetna Jain (11 hours later)

Hi Doctor

I have got my beta HCG done and it is 8.6, does it mean I am pregnant. If it does, what options do i have to abort this pregnancy as soon as possible. Do I have to undergo a surgery or medicines would suffice? How many weeks pregnancy can be aborted? How many weeks do you think I am at?
I have taken an appointment for tuesday morning 8.20 am.
Please suggest as I am now panicking.

Regards XXXXXX

Answered by Dr. Chetna Jain (13 hours later)

Hi XXXXXX
Its a very low reading but does not determine if its an ongoing pregnancy.
Please do a repeat beta hCG 48 hrs from 1st reading and show with both reports.
Dont panic. This pregnancy can't be more than 4 weeks.
Hope that helps
Regards

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Chetna Jain (27 hours later)

Hello Doctor

I have bad cramps in my stomach and backache and I have got my periods i think since I am bleeding since yesterday. It was negligible yesteraday and It has increased today which is why I could not make it up for the appointment today and also I was not sure if I should get a beta HCG done now or not.

My Beta Hcg on 23rd is 8.5 mIU/ml
Thyroid Stimulating Hormone is 3.72 UIU.ml
FSH is 5.6

I got all these tests done on 23rd early morning.

Please suggest why my HCG was high? Should I get another beta HCG done? and When?

Also, please suggest what all of this implies? and should i XXXXXX you during the periods I am having or after these are over.
Are these periods or after effects of medicines?

Thanks
Regards XXXXXX

Answered by Dr. Chetna Jain (22 hours later)

Hi
Most likely it was a very early pregnancy which went off.
There is no reason to worry now.
Pl stop bothering now.
Pl keep an account of the future cycles.
This time the bleeding may last longer becuase it has come after long gap.
You may do another beta hCG after 7 days but its not too important.
Best wishes

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

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