QuestionHello,
I had a D&C for an incomplete abortion on October 21, 2008. I had taken the
abortion pill and it was unsuccessfull. I am 34 and in good health. I didn,t
want to be a single mom. I have been on micrgestin 1.5/30 since with no
periods. i have been off now for 3 weeks and saw my dr today. They did
blood work for thyroid, brain toumers and preg. All three likley neg. i hope:)
i go back in 2 weeks to see my obgyn rather than the NP and am nervous
about what will happen next. What are the possibilities? I know the pill is
supposed to help regulate periods so i am very confused and worried about
all that i have read on the internet. I understanf they may have to do a
procudre where the go in with a scope. Could you perhaps explain what
happens next when missed periods start?
Thanks so much,
L
AnswerHello Laura,
There are several possiblities causing you not to have a period after birth control pills. That is certainly unusual, however, not unheard of will today's low dose pills.
At this point, I would proceed as follows:
1. Hormonal testing to see if there is an ovarian, thyroid or pituitary problem (FSH, LH, TSH, Prolactin, Estradiol) and another pregnancy test.
2. Pelvic ultrasound to make sure that there is no ovarian cyst causing the problem (ovarian cysts can be hormonally active and prevent menses)
3. I would do a hysteroscopy, whereby a small scope is passed into the uterine cavity to rule out scar tissue formation that resulted from the D&C (Asherman's syndrome). By the way, I do this in my office with a very small pediatric scope so that anesthesia and sedation are not needed. Also it minimizes the pain.
4. If all those are negative, then I would try the birth control pills on a 7-day cycle. That is 1 tablet 3 times per day for 7 days, then stop. A period should ensue.
I hope this helps,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
