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Missing period after delivery. Pregnancy test negative. No period after taking meprate. What to do?

Mar 2016
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Practicing since : 2011
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Hi my wife had delivered a baby in August 2012. After three months she started her menses but last month she missed it. We have taken pregnany test and it was negative. When we called our doctor she prescribed Meprate tab for five days but it didn't helped. Please advise
Posted Tue, 16 Apr 2013 in Women's Health
Answered by Dr. S Patra 3 hours later

Thanks for writing to XXXXXXX platform. I am trying to solve this problem.

Women on exclusive breast feeding (EBF) sometimes present with mild vaginal bleeding/ spotting in the first 6 months or thereafter but do not experience normal menstrual bleeding at all. It is called lactational amenorrhea (LA) in medical term.

In case of irregular or absence of breast feeding, she may get her normal period within 3 months of child birth. In most cases, hormonal imbalance and stress are the main cause for irregular delayed period.

Other co-existence factors are ovarian cyst, anxiety/ emotional upset, irregular eating habit, high prolactin level, weight change, thyroid disorder, psychological factor etc.

Here, you need to undergo one blood test for beta-HCG to exclude pregnancy completely as home pregnancy test is not always reliable. In addition, one pelvic ultrasound scan and some hormone tests including thyroid profile, blood sugar & prolactin level are essential to pin point the diagnosis.

Complete treatment depends on underlying etiology. Following taking Meprate, period usually starts within 7 days. If she does not get it, she may need to take cyclic progesterone therapy (3 weeks on for 21 tabs and 1 week off for period) to regularize her period.

In this scenario, I suggest to consult with her gynecologist for proper guidance through above investigations & take suggestive measures accordingly.

In the interim, she must do the following things:

1) Avoid stress/ anxiety/ emotional upset by regular deep breathing/ yoga.
2) Take healthy diet with iron supplements and consume more vegetables/ fruits & drink more water.
3) Keep bowel habit regular & maintain personal hygiene properly.
4) Control body weight by regular physical exercise.
5) Take a sound sleep with complete relaxation.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish her good health in future.

Dr Soumen
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