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Irregular periods, brown spotting, taking progesterone, history of miscarrige. Will this affect me getting pregnant?

May 2013
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Practicing since : 2006
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Hello, i am 32 years old and trying to conceive baby number 2 for 8 months now. I had a missed miscarriage in 2009, which was medically handled by a D&C in April 2009. But after the D&C, I got an infection which led to another D&C in late April 2012. I then got pregnant in May 2012 and gave birth to a healthy baby boy in February 2012.
Unfortunately in July 2012, I suffered another miscarriage at 10 weeks, but this time it was a natural miscarriage with no medical intervention. But since then my periods have been very light and irregular. For the past 5 months, I only get dark brown spotting for 2 days, it is extremely light that I do not need to wear a sanitary towel or tampon. I had an ultrasound in March 2012 and was told that everything looks ok. But I am very worried as I have never had such irregular and light periods.
I also had a Pap Smear in march 2012 which came out ok, so the doctor put me on asprin (daily), Ovusitol (twice a day) and progesterone suppositories 2 days after ovulation for 11 days.
Before the miscarriage, my periods were regular, 28 days, ovulation on day 14. But since the last miscarriage, my periods are between 21 and 24 days, ovulating on day 10-12. When I take the progesterone, I get a normal period bleed that last 7 days, but if I miss a month (like this month), all I get is two days of brown spotting.
I have also began to take my BBT this month, my temperatures have not dropped, but I started getting the brown spotting today, this is around the time I should expect my period. I know I am not pregnant as I have done 5 pregnancy tests. Please can you help explain why my periods have become so irregular and why I only get 2 days of brown spotting every month instead of a proper period? Will this affect me getting pregnant?

Posted Sat, 2 Jun 2012 in Women's Health
Answered by Dr. Sree Gouri SR 3 hours later

Thanks for the query.

1. Hypomenorrhea (decreased menstrual flow during periods) can be explained by,
- Asherman’s syndrome : As you have history of dilatation and curettage (D&C) and infection, there is a possibility of formation of uterine adhesion. This may lead to infertility. This condition can be best diagnosed by hysteroscopy.
- emotional stress and low body fat can also lead to hypomenorrhea.
-excessive blood loss after D&C can lead to anemia which can lead to hypomenorrhea.

2. Absence of dropping of temperature during pelvic inflammatory disease, it can also cause irregular cycles and hypo menorrhea.

4. Thyroid abnormalities can also lead to menstrual irregularities.

Now what you can do is,
- get hormonal analysis to detect the levels of LH, FSH, Estrogens, Progesterone, prolactin, T3,T4,TSH levels after consulting your gynecologist, which will diagnose the possible cause and treatment can be taken according to that.
- get one ultrasound done to find out uterine or ovarian abnormality, if needed you can go for hysteroscopy with your doctor's advice.
- improve your general condition and take iron, calcium, Vit D supplements with her advice. Meanwhile continue the tablets given by her.
- avoid stress and take help of your family members in dealing with this problem.

Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please do not forget to accept it.

Take care
Above answer was peer-reviewed by
Follow-up: Irregular periods, brown spotting, taking progesterone, history of miscarrige. Will this affect me getting pregnant? 2 hours later
Hello Dr Gouri,
Thank you for your reply.
Is it possible for me to have Asherman's syndrome even though I got pregnant twice in a space of 2 years after my last D&C? I did ask my OBGYN this question in March 2012 and he said that the fact that I already got pregnant twice after suggests that I do not have Asherman's syndrome.
I did lose a lot of weight before I got pregnant in July 2011 due to a heavy work load, but I have now regained the weight and I am under no emotional stress.
My last blood test was in March 2012 which showed normal levels for my Thyroid and prolactin. I not sure if my OBGYN checked for the other things that you suggested, but I will ask.
My last ultrasound was in March 2012 and the doctor said that my uterus lining and ovaries looked healthy. Is this possible to ascertain via an ultrasound or is a hysteroscopy necessary?
My BBT graph suggested that I did ovulate last month at day 10, I’m saying this based on 3 temperature spikes after cycle day 10 and a positive OPK on day 10. But obviously, I do not know for sure if I did ovulate.
I am not anaemic and I have been taking pregcare tablets everyday as advised by my OBGYN.
The reason why I am writing this is because my OBGYN doesn’t seem to be too concerned about my lack of periods and I would like to get a second opinion as this is not normal for me. He has said that the progesterone, ovusitol, asprin and vitamins combination should regulate my period in the next few months. It’s now been 3 months since I have been taking this stuff, it helps whilst I’m taking it, but if I stop taking the progesterone, my periods go back to two days of brown spotting. I’m very worried and believe that the last miscarriage has caused this irregularity with my period, even though I am not a doctor; I know my body very well.
Lastly, according to my last ultrasound, I do not have any cyst on my ovaries or any fibroids in my uterus.
Answered by Dr. Sree Gouri SR 20 hours later
I told Asherman's syndrome as one possibility for your hypomenorrhea. If your doctor ruled out the possibility of Asherman's syndrome because of D&C s, the other possibilities to have this are,
-You didn’t mention how you delivered the baby either by caesarean or vaginal delivery. In case of caesarean section, sometimes adhesions also can occur after surgery.
- as you had one miscarriage after delivery with no medical intervention, in case of presence of any minimal retained products at that time can also lead to formation of adhesions.
You discuss this with your gynaecologist and if needed go for hysteroscopy which can also rule out possibility of any past pelvic inflammatory disease. If previously complete hormonal evaluation was not done, you can get it done this time.
As your BBT and OPK both showed that ovulation has occurred it has to be considered.
You continue the tablets given by your gynaecologist as sometimes it takes longer time to hormonal levels to get corrected. After undergoing above tests depending on their result he may suggest you new treatment option.
Wish you Good Health; if you are satisfied with my response please accept it.
Take care

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