Post-Miscarriage Amenorrhea: Understanding Irregular Periods & What to Expect

Question
Hello Doctor... My menstrual cycle has never been consistent. Since I've started I could go up to two to three months without a period. On January 7, 2011 I miscarried at 8 weeks pregnant. My OBGYN told me to treat it as a normal period and told me not to use tampons. He ordered no DNC, ultrasound, or follow up appointment. I had no period until the first week of July and it lasted around 4 days. It was a regular period from what I can remember. Heavy the the first 2 days and then it tapered off. I then went until the first week of September to get another period. Same symptoms. It is now the second week of November and here I am with no period. I've talked with my Internal Medicine Doctor and I've done all my thyroid labs and they all came back normal. A couple low but still in range. I am thinking that the next step would be an ultrasound and maybe an injection to induce my period. I was also considering going on some form of birth control to try to get it going and regulated. What would your advice be??

Answer
You have yourself said that your periods are always irregular. Therefore I am not surprised that your periods are being erratic. If you are worried about being pregnant then an ultrasound would help. But if you are not pregnant then an USG or induction of periods would be of no benefit, because the next cycle will be the same again. Therefore my advice would be to wait for your period and the go on the oral pill for 6-8 cycles. This should normalize your periods and also provide birth control.