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Had Missed Period, HPT Negative. Told To Be Due To Anxiety And Stress, Recommended Meprate. Suggest?

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Posted on Fri, 11 Oct 2013
Question: hi doctor,
i m 29 yrs old, i missed my menstrual this month, she checked for pregenancy and it was negative.she said may be it is caused due to anxiety and stress and recommended meprate tablet for 5 days
1. i took for 5 days and waited for 5 days.this is my 6 th day wait?after how many days will menstrual happen
2. how long should i wait before i actually consult her again
3. how does this tablet work
4. can i try for preganancy immediately after this menstrual cycle
5.will it affect ovary or egg by any chance
6.will the egg be formed as usual after taking this tablet this month

this is the first time it has happened to me, that i missed my period.and preganacy is negative


regards XXXXXXX
doctor
Answered by Dr. Dr. Soumen Patra (18 hours later)
Brief Answer:
Wait one week after stopping MEPRATE.

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us on Healthcare Magic. Followings are my comments:

1) Meprate contains medroxyprogesterone acetate as composition. Most women get their period or withdrawal bleeding within 7 to 10 days after stop taking them. However, you need to repeat the pregnancy test (blood or urine) if you do not get your period after 7 days of waiting from stopping the medicine.

2) You would consult with your doctor after one week waiting from the day of stopping the meprate. Some investigations like ultrasound scan, hormone test may be required to rule out underlying cause like ovarian cyst, hormonal imbalance, thyroid disturbance, high prolactin, pelvic infection etc.

Stress and hormonal imbalance are the most common cause of late period in absence of pregnancy. You must do regular meditation or yoga to avoid stress and take sound sleep, balanced diet, drink more water & keep bowel habit regular. These will help to hasten your period.

3) Meprate is a synthetic progestogen structurally and functionally related to natural progesterone. It basically causes withdrawal bleeding. Women take progesterone for several days and then do not take for few days. This drop in progesterone (or sudden withdrawal) triggers the bleeding. It occurs about 5-7 days after stop taking them. This is healthy for the uterine lining which thickens with the effect of external progesterone, then sheds (sloughs off) in response to sudden drop in progestin.

4) Yes, you can try for pregnancy after this menstrual cycle over. You need to do unprotected sex close to ovulation day (approx 14 days prior to next period) or fertile days (12th to 18th day of each 28-30 days cycle) to maximize the chance of pregnancy. Here, you can use ovulation prediction kit or LH kit available in market to predict the ovulation day and prepare for that. Along with, you must take folic acid & vitamin-E supplement (for 3 months) with balanced diet and control body weight.

5) No, it does not effect on ovulation or ovary within recommended dose. It acts like natural body progesterone hormone. So, don’t be worried about that.

6) Yes, your ovulation will be preserved and egg will form naturally in spite of taking this medication. It has no effect on them in usual doses. When it is used as contraceptive method like DEPO SHOT, it hampers regular ovulation and prevent possible conception. Otherwise, it has function like natural progesterone hormone.

Hope, I have answered your queries. If you need any clarification, you can freely ask me.

Wish your good health and take care yourself.

Regards,
Dr Soumen

For future query, you can directly approach me through
WWW.WWWW.WW
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Soumen Patra (48 hours later)
Thank u so much doctor for your answer

its been 10 days wait and still i havent got my period after taking meprate tablet.
Now she has suggested ovral tablet for 5 days..
1. Just for second opinion , is ovral tablet the next immediate action towards the menstrual if meprate doesnt work
2. is there any alternate approach
3. she told me to take one mrng and one night for 5 days
4. is it like again i have to wait for 5 days to expect my menstrual.
5.i did thyroid,prolactin,blood, ct scan of full pelvic region
everything is within limits, but prolaction content came as 26 ng/ml when the range was within 23 ng. so she suggested cabergolin tablet- one for each week.
no cysts were found,endometrium thickness was good.the report was very fine expect this prolactin content, just above normal.
6. Wat is the high prolactin level for non pregnant women?
7. My periods was very normal till date, but last month when we started to plan for baby, this month i lost my menstrual and its been 55 days. no pregnancy-its negative and still no periods.
took meprate - did not happen
now taking ovral tablet, i need to wait and watch

query is can i try for pregnancy once this cycle finishes
she suggested to take siphene tablet from day 2 of menstrual
and suggested for a follicular scan on day 12

i m really worried why my period did not happen when i just started planning for kid.

thanks, XXXXXXX
doctor
Answered by Dr. Dr. Soumen Patra (1 hour later)
Brief Answer:
Detailed answers are given.

Detailed Answer:
Hello XXXXXXX

Thanks for follow up query. Followings are my comments:

1) Yes, if progesterone pill like meprate fails to get withdrawal bleeding, next step is giving trial with combined estrogen and progesterone pill like Ovral. It is the alternate approach to correct hormonal imbalance.

2) You would take Ovral medication as per your doctor's direction and you will definitely get your period within 3 to 5 days waiting.

3) High prolactin is one of the reasons of delaying period as other reports are normal. It should be normal to get your period. Take cabergolin as per direction to suppress prolactin level.

4) High-prolactin level in non-pregnant women has several reasons like pituitary tumor or prolactinoma, hypothalamus dysfunction, thyroid problem, effect of certain medication like H2 blocker, methyldopa, metoclopramide etc.

However, your prolactin level is slightly high or just above the normal range and it may be temporary due to 1) Emotional or physical stress 2) High-protein meal 3) Intense breast stimulation 4) moderate exercise etc.

5) Yes, you can try for pregnancy after this cycle over and should take siphene from D2 of cycle. Follicular scan is recommended to check proper ovulation from D12 to D16.

Additionally, you can use ovulation prediction kit or LH kit available in market to predict and track the ovulation day and prepare for unprotected sex to maximize the chance of pregnancy.

Hope, I have answered your queries. If you don't have any other query, you can close the discussion.

All the best. Good luck.

Regards,
Dr Soumen
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
doctor
Answered by
Dr.
Dr. Dr. Soumen Patra

OB & GYN Specialist

Practicing since :2011

Answered : 4058 Questions

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Had Missed Period, HPT Negative. Told To Be Due To Anxiety And Stress, Recommended Meprate. Suggest?

Brief Answer:
Wait one week after stopping MEPRATE.

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us on Healthcare Magic. Followings are my comments:

1) Meprate contains medroxyprogesterone acetate as composition. Most women get their period or withdrawal bleeding within 7 to 10 days after stop taking them. However, you need to repeat the pregnancy test (blood or urine) if you do not get your period after 7 days of waiting from stopping the medicine.

2) You would consult with your doctor after one week waiting from the day of stopping the meprate. Some investigations like ultrasound scan, hormone test may be required to rule out underlying cause like ovarian cyst, hormonal imbalance, thyroid disturbance, high prolactin, pelvic infection etc.

Stress and hormonal imbalance are the most common cause of late period in absence of pregnancy. You must do regular meditation or yoga to avoid stress and take sound sleep, balanced diet, drink more water & keep bowel habit regular. These will help to hasten your period.

3) Meprate is a synthetic progestogen structurally and functionally related to natural progesterone. It basically causes withdrawal bleeding. Women take progesterone for several days and then do not take for few days. This drop in progesterone (or sudden withdrawal) triggers the bleeding. It occurs about 5-7 days after stop taking them. This is healthy for the uterine lining which thickens with the effect of external progesterone, then sheds (sloughs off) in response to sudden drop in progestin.

4) Yes, you can try for pregnancy after this menstrual cycle over. You need to do unprotected sex close to ovulation day (approx 14 days prior to next period) or fertile days (12th to 18th day of each 28-30 days cycle) to maximize the chance of pregnancy. Here, you can use ovulation prediction kit or LH kit available in market to predict the ovulation day and prepare for that. Along with, you must take folic acid & vitamin-E supplement (for 3 months) with balanced diet and control body weight.

5) No, it does not effect on ovulation or ovary within recommended dose. It acts like natural body progesterone hormone. So, don’t be worried about that.

6) Yes, your ovulation will be preserved and egg will form naturally in spite of taking this medication. It has no effect on them in usual doses. When it is used as contraceptive method like DEPO SHOT, it hampers regular ovulation and prevent possible conception. Otherwise, it has function like natural progesterone hormone.

Hope, I have answered your queries. If you need any clarification, you can freely ask me.

Wish your good health and take care yourself.

Regards,
Dr Soumen

For future query, you can directly approach me through
WWW.WWWW.WW