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Having no periods after D&C done for removing left over placenta. Prescribed Provera. Suggest?

DOCTOR OF THE MONTH - Mar 2013
Mar 2013
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Hi, I had a baby 4-1-13 then a D&C on 4-17-13 for left over placenta, I haven't had my period ever since the d&c so my OB did a sono and it showed that I should get a period within 2 weeks, in case I didn't he prescribed provera 10mg x5 days. The 2 weeks went by and I DIDN'T get my period so I took the provera, its been 5 days since I took my last pill and still no period!!!! Should I wait more? I have been having some cramping and pms but no period! Also today my temp was 99 99.8 100 what could this temp mean?
Posted Tue, 20 Aug 2013 in Pregnancy
 
 
Answered by Dr. Aarti Abraham 38 minutes later
Hello,

Thanks for trusting us with your health concern.

Firstly, you have not mentioned if you are breastfeeding or not. If you are, then the lack of periods is easily explained.

If not, then sometimes post a D and C, excessive lining of the uterus gets removed and you fail to have periods for up to some months following the D and C. In your case, as the OB has already done a sonogram, he must have ensured that the uterine lining is beginning to grow back.

After childbirth, hormonal levels go awry, so Provera (progesterone content) ensures that the uterine lining gets shed off in time, leading to a normal period. Ideally, you should wait for a week before arriving to the conclusion that the Provera did not work.

If you fail to menstruate (this might only be a light spotting in response to the drug, even that is counted as withdrawal bleed), then consult your gynecologist again - additional hormones maybe required.

Regarding the temperature, it is slightly elevated, if you have persistent raised temperature, or it rises more, accompanied by chills, or a foul smelling discharge, cramping pain etc, then it could indicate a pelvic infection caused by the D and C.

Take care.
Please feel free to ask for further clarifications.
Above answer was peer-reviewed by
 
Follow-up: Having no periods after D&C done for removing left over placenta. Prescribed Provera. Suggest? 24 minutes later
No I am not BF.

Infection from D&C? It's been over 3 months is it possible to have an infection after so long?

So it's been five days since my last provera. Should I wanIt another 7 days?
 
 
Answered by Dr. Aarti Abraham 1 hour later
Let me clarify:

1. Not infection FROM the D and C. But, a D and C as I said, can lead to scraping off of the entire lining of the uterus - that is a fertile ground for infection. Your symptom coupled with fever, points towards a pelvic infection.

2. In this circumstance, retained bits is always a suspicion; but as you do not have any bleeding / spotting / unrelenting pain / foul discharge, retained bits is less likely.

3. Therefore in my opinion, you should wait for a total of 7 days after stopping Provera. That means, wait for another couple of days, stretching maximum to another 4 days , before seeing your doctor.

Hope it is clear and detailed now. Let me know if you need clarifications.

Regards
Above answer was peer-reviewed by
 
Follow-up: Having no periods after D&C done for removing left over placenta. Prescribed Provera. Suggest? 5 hours later
I'm having my pap this Tuesday, would it show if inhave a pelvic infection?

Or how will that be diagnosed?
 
 
Answered by Dr. Aarti Abraham 2 hours later
It can be diagnosed by a per speculum examination, where signs of infection such as discharge, redness etc would be visible.
Your doctor would have to see you with a speculum in order to take a Pap smear, hence the infection would be diagnosed then, if you have one.
If there is visible discharge, then a culture of the discharge will specifically identify the particular infecting organism.
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Follow-up: Having no periods after D&C done for removing left over placenta. Prescribed Provera. Suggest? 40 hours later
I had my pap done today and the dr did a vaginal sono and he said that I should be getting a period within a week and that if I don't the. Inhave to take more provera then if that didn't work then I would need a 2nd D&C. My question is, since I haven't had a period for 4 months, is the blood accumilating? If so do I run a risk of having a sever infection bcuz of all the blood in my utures? If so how will that infection be diagnosed? With a vaginal swab?
 
 
Answered by Dr. Aarti Abraham 4 minutes later
Right.
The reason you have not had a period for 4 months, is because of damage to the basic lining of the uterus due to the first D and C.
This could result in formation of scar tissues and adhesions, and prevents the normal endometrial lining from growing and leading to a period.
That is why Provera is prescribed, as it causes thickening of the lining of the uterus, if the blood had been accumulating, you would not have required medication to make the lining grow.
The blood accumulated in the uterus would also show up on the sonogram, and you would be having severe fever, signs of sepsis, uterine tenderness etc, which is not the case.
It would help greatly if you post the reports of the sonogram done ( upload the exact report I mean ).
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Follow-up: Having no periods after D&C done for removing left over placenta. Prescribed Provera. Suggest? 31 minutes later
Well the dr said that the lining looked ready for a period. Would the lining be abnormal if I did have blood accumulated ?
 
 
Answered by Dr. Aarti Abraham 1 minute later
If you had blood accumulated inside, it would be visible as pure blood within the cavity.
As a collection of blood apart from the lining of the uterus I mean.
That he said the lining was ready for a period, in itself means, that the lining is grown enough to be shed off for a period, but there is no collected blood inside the cavity per se.
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Follow-up: Having no periods after D&C done for removing left over placenta. Prescribed Provera. Suggest? 17 hours later
I called my DR and asked about my sono, he said that there was some tissue but no blood or clots! Can I still get an infection?

Also every time I ovulate or have. My period I get EXCRTUIATING pain in my rectum and pelvis when I walk pee or try to go#2! This has been. Going on for years. But when I've been pg I don't experience it! What could it be?
 
 
Answered by Dr. Aarti Abraham 4 hours later
The verbal comments from your doctor are only confusing the picture.
Ask him for the exact ultrasound report.
If there is some tissue inside, yes, you could have an infection.
You could be having endometriosis, a condition where there is extreme pain during the periods, due to increased blood flow to pelvic organs.
Once you are 6 months post delivery, you can be examined for the same.
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Follow-up: Having no periods after D&C done for removing left over placenta. Prescribed Provera. Suggest? 33 minutes later
But if I was at the risk for an infection my doctor would of told me right away right? I hope! And treat me ASAP! Which his not! He said we were going to wait to see if I get my period then if I don't ill take provera again
 
 
Answered by Dr. Aarti Abraham 3 minutes later
Yes, he would have told you.
I am just telling you the possibilities.
Please understand that he has seen you, and I have to look at the hypothetical picture with all possibilities.
That is why I requested the ultrasound scan report.
If you were at any risk, he would have not asked you to wait.
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Follow-up: Having no periods after D&C done for removing left over placenta. Prescribed Provera. Suggest? 1 hour later
Thank u DR you've been so helpfull! If I obtain my ultrasound ill upload ASAP!
 
 
Answered by Dr. Aarti Abraham 3 minutes later
Please do upload the report.
That is the key element based on which I will be able to provide you a picture that will be much more clear to you, and will remove most of your confusion.
Thanks for the appreciation.
Please feel free to write back anytime.
All the best, dear.
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