Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Delay In Menstruation?
Question: Hi,
I am 29 years old. I and my husband are planning to conceive.
My last period date was 18th Oct. It has been almost 6 weeks now since I have had any periods.
I went to the Gynecologist last week who tested me for pregnancy. It came out negative. I also had a very tiny polyp who the Gynecologist did not think of as much of a concern.
'
Since I also was having a stabbing pain back then, (which has reduced now) the Gynecologist had advised me to take Birth control pills and then have a laproscopy.
My question is should I wait for another week or so and get myself tested again as sometimes the pregnancy results are not very accurate. Or should I immediately start taking the BCPs and eventually the laproscopy? Or should I request my family doctor to write me a prescription that will help bring periods
Thank you so much
I am 29 years old. I and my husband are planning to conceive.
My last period date was 18th Oct. It has been almost 6 weeks now since I have had any periods.
I went to the Gynecologist last week who tested me for pregnancy. It came out negative. I also had a very tiny polyp who the Gynecologist did not think of as much of a concern.
'
Since I also was having a stabbing pain back then, (which has reduced now) the Gynecologist had advised me to take Birth control pills and then have a laproscopy.
My question is should I wait for another week or so and get myself tested again as sometimes the pregnancy results are not very accurate. Or should I immediately start taking the BCPs and eventually the laproscopy? Or should I request my family doctor to write me a prescription that will help bring periods
Thank you so much
Brief Answer:
Repeat pregnancy test and get period by medicines
Detailed Answer:
Hello XXXXXXX
In my opinion the last option seems the most correct - namely, ask your doctor to write a prescription for you to get the period. This will be a course of Progesterones for 5 days.
Before this, however, it may be worthwhile to repeat the urine pregnancy test in the first morning sample of urine tomorrow.
See XXXXXXX if you had an occasional delayed period earlier or even if you have never had one, this could be a delayed egg release and a delayed start of pregnancy. Do you understand? Let me explain differently - in a normal 28 day cycle the release of egg occurs about 2 weeks before a period that is about to come. But, if for some reason, the release of egg is delayed, and the start of pregnancy will be delayed. If there is no pregnancy then the coming period will also be delayed. In case the egg release didn't happen at all, then the next period will not be predictable - it will be irregular, delayed.
So, in case this is delayed ovulation (release of egg), I would suggest this sequence - repeat pregnancy test; if negative take Progesterone medicines prescribed by your doctor to get the period.
Pregnancy tests in the urine are very sensitive and very reliable. They pick up pregnancy if the HCG level is more than 25 IU/litre. If one wants even more sensitive tests then one can do the same HCG test in blood - sensitivity 5 IU/litre. But this may not be required in your case. Urine pregnancy test should suffice.
A polyp inside the uterus is tested by Hysteroscopy - telescope inside uterus. Laparoscopy deals with all problems outside the uterus. The polyp seen in your case - I would recommend repeating, after your period, a Trans-vaginal ultrasound (not Trans- abdominal) to confirm that it still exists. Unless it's very big, at this stage, if it's not causing abnormal bleeding, you could even leave it be.
Yes, birth control pills improve conditions of endometriosis. A diagnosis whether you have this can be made on examination and ultrasound. I wouldn't like to suggest these pills empirically, without a diagnosis, at this point, however.
At this point, my recommendations are :
1. Repeat urine pregnancy test, first morning sample, tomorrow. (Not after 1 week). Pregnancy can be confirmed with an ultrasound.
2. If negative, take pills to get the period.
3. It's important to find out that if this is not a pregnancy, then why was the period delayed? Therefore having done the above 2 steps I would suggest that you discuss with your doctor who will look into this issue. Remember that this will be important because, as I pointed out earlier, if period is delayed, do a reverse step and focus on the release of egg. The egg release must have had a problem if period is delayed. Since you are trying to conceive see how important it is to look into this.
4. I would not recommend laparoscopy at this stage based on the information that I have.
Regards. All the best.
Dr Nirja Chawla
Repeat pregnancy test and get period by medicines
Detailed Answer:
Hello XXXXXXX
In my opinion the last option seems the most correct - namely, ask your doctor to write a prescription for you to get the period. This will be a course of Progesterones for 5 days.
Before this, however, it may be worthwhile to repeat the urine pregnancy test in the first morning sample of urine tomorrow.
See XXXXXXX if you had an occasional delayed period earlier or even if you have never had one, this could be a delayed egg release and a delayed start of pregnancy. Do you understand? Let me explain differently - in a normal 28 day cycle the release of egg occurs about 2 weeks before a period that is about to come. But, if for some reason, the release of egg is delayed, and the start of pregnancy will be delayed. If there is no pregnancy then the coming period will also be delayed. In case the egg release didn't happen at all, then the next period will not be predictable - it will be irregular, delayed.
So, in case this is delayed ovulation (release of egg), I would suggest this sequence - repeat pregnancy test; if negative take Progesterone medicines prescribed by your doctor to get the period.
Pregnancy tests in the urine are very sensitive and very reliable. They pick up pregnancy if the HCG level is more than 25 IU/litre. If one wants even more sensitive tests then one can do the same HCG test in blood - sensitivity 5 IU/litre. But this may not be required in your case. Urine pregnancy test should suffice.
A polyp inside the uterus is tested by Hysteroscopy - telescope inside uterus. Laparoscopy deals with all problems outside the uterus. The polyp seen in your case - I would recommend repeating, after your period, a Trans-vaginal ultrasound (not Trans- abdominal) to confirm that it still exists. Unless it's very big, at this stage, if it's not causing abnormal bleeding, you could even leave it be.
Yes, birth control pills improve conditions of endometriosis. A diagnosis whether you have this can be made on examination and ultrasound. I wouldn't like to suggest these pills empirically, without a diagnosis, at this point, however.
At this point, my recommendations are :
1. Repeat urine pregnancy test, first morning sample, tomorrow. (Not after 1 week). Pregnancy can be confirmed with an ultrasound.
2. If negative, take pills to get the period.
3. It's important to find out that if this is not a pregnancy, then why was the period delayed? Therefore having done the above 2 steps I would suggest that you discuss with your doctor who will look into this issue. Remember that this will be important because, as I pointed out earlier, if period is delayed, do a reverse step and focus on the release of egg. The egg release must have had a problem if period is delayed. Since you are trying to conceive see how important it is to look into this.
4. I would not recommend laparoscopy at this stage based on the information that I have.
Regards. All the best.
Dr Nirja Chawla
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. Vaishalee Punj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
