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What Causes Irregular Periods?
Question: I had a baby in March 13. Bottle fed. Periods didn't return afterwards. GP did all hormone bloods, all fine. Referred to gyne who advised me to go back on pill. Back on pill in Oct 13. Got bleed in between. Went off pill in feb 14. Natural period on 4th March and nothing since. Not pregnant, please advise.
Brief Answer:
DISCUSSED BELOW
Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Have you confirmed that the pregnancy is conclusively negative ?
With irregular cycles, often, you need a blood B HCG test or a pelvic ultrasound to infer.
Also, you could be having PCOD - polycystic ovarian disease.
More likely, during childbirth ( you have not specified vaginal or C section ) - the endometrium ( lining of the uterus ) can get damaged due to post partum excessive bleeding or infection or retained placental bits.
Also, if you lost a lot of blood during labour, post partum amenorrhoea might result.
Since you did not breastfeed at all, normal cycles should have resumed within 3 months.
Did you have regular menstrual bleeds earlier, no issues in the past ?
Also, here is a checklist of the workup that should be done -
1. Pelvic ultrasound scan, measurement of endometrial stripe and endometrial biopsy.
2. Hormones - FSH, LH, TSH, Prolactin, OGTT, DHEAS, Free testosterone, Lipid profile.
ANy of the following factors present - stress, anxiety, weight gain or drastic loss, late nights, binge eating, travelling, change in climate or altitude, ingestion of hormonal medications or other medications that commonly affect cycles ( antidepressants, steroids ) etc ?
Please do write back with more details.
All the best
Please feel free to discuss further.
Above answer was peer-reviewed by :
Dr. Yogesh D
I would have been on the pill for years and years before we decided to try for a baby so I would always get false bleed in between. I had vaginal birth and no excessive bleeding during labour or afterwards. I was private patient so well looked after by gyne. I had prolactin levels checked by gp and all other hormone levels are normal so really I don't know what the problem is. Def not pregnant.
Brief Answer:
AS BELOW
Detailed Answer:
Are you really sure all the tests listed above have been done - and a pelvic ultrasound with measurement of the endometrial thickness ?
If yes, then there is no apparent reason for this lack of periods.
It is best to continue the pill for a few more months, and then see if the normal cycles resume, if the workup is normal, nothing more remains to be done.
You might just be taking a longer time than normal to resume menses after childbirth.
Above answer was peer-reviewed by :
Dr. Yogesh D
Can you confirm what the pelvic ultrasound to measure the endometrial thickness would confirm thanks
Brief Answer:
EXPLAINED BELOW
Detailed Answer:
Hi,
A pelvic ultrasound will serve the following purpose -
1. It will measure and evaluate the endometrium. If the endometrium is too thick, and not getting shed off, it indicates hormonal imbalance, and a biopsy would help, and cyclical progestin therapy.
2. If it is too thin or irregular or calcified, it indicates damage during childbirth.
3. It will evaluate any possible cysts on the ovaries that can lead to irregular cycles.
Regards,
Above answer was peer-reviewed by :
Dr. Raju A.T
My periods returned yesterday about a week late. Do I still need to follow through on your suggestions?
Brief Answer:
AS BELOW
Detailed Answer:
Yes, if the irregular periods persist over the coming few months.
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
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