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Post-Abortion Bleeding & Period Irregularities: Causes & What to Expect


Question
QUESTION: I had a D&C on July 11, and no period since then until Oct 2, I had two ultrasound in between July 11 and Oct 2, the result was the endometrium was thickened measuring 21mm, the first ultrasound says it's focal, the 2nd ultrasound says it's diffuse, dianostitic onsideration inlcude retained products of conception, clot or polyp.  On Oct 2, I started bleeding like a period but volumn was more than a period, the doctor asked me to take 8 apo-misoprostol 200mcg tablets on the 3rd of Oct, I bled more on Oct 3 and 4th, and saw some clot look stuff comong out. On Oct 5th, I bled less at night, and in the next two days, the bleeding reduced gradually.   I wonder if misoprostol will thin the endometrium, do I need to take some estrogens to help recover the line of uterus?  Is my situation normal?

ANSWER: Dear Cathy,
As long as your pregnancy test is negative, there is nothing to be concerned about. It sounds to me like you are getting good medical care. Taking misoprostol is a good approach.  You do not need estrogens as misoprostol will not cause a problem to the lining of your uterus.
I hope this is helpful.
Doctor Joan

---------- FOLLOW-UP ----------

QUESTION: Thanks Dr. Joan:

The doctor who gave me misoprostol also prescribed me conjugated estrogens (20 tablets) along with medroxyproges (10 tablets) saying it would help to make the line of uterus better, that's why I thought misoprostol might cause problems to the line of uterus.  

So is it because estrogens could help reduce/stop heavy bleeding? if so, in my case, there's no need for me to take estrogens, right?  Also I want to do another ultrasound once I stop bleeding, I wonder if taking estrogens would have any impact to the ultrasound result, such as thickening endometrium?  that's another reason I did not take estrogens, but would like to get some confirmation.

If everything is normal after ultrasound is done, when will my next period return?  in a month?  

Answer
Hi Cathy,
Your situation is not typical, and I feel uncomfortable giving you advice, since I don't have your medical records. The doctor probably prescribed the estrogens to help regulate your periods - they say to "stabilize" the endometrial lining.  It would be best to ask your doctor the same questions you're asking me - they will be in a better position to advise you.  
Sorry I couldn't be of more assistance,
Doctor Joan