Abnormal periods since miscarriage
Question
I had a miscarriage almost exactly a year ago. Since the miscarriage I have had very abnormal periods and have not been able to get pregnant again. I was put on Provera to start my period last month because it had not came in two months. What can I do to get this straightened out?
Answer
Last Updated: July 22, 2013
Based upon the information provided, I would suspect that you are not ovulating regularly or al all. Without a normal ovulation, you would not produce progesterone, the hormone that is dominant in the latter half of the cycle (luteal phase). If you had a period following provera, then that suggests that you are producing estrogen, but that you were lacking progesterone.
Why would you not be ovulating? There are a number of possibilities. Are you getting close to “the change of life” (menopause)? As a woman nears menopause (around 40 years old), then often she will begin to skip ovulations. This will result in less frequent periods, and will increase the likelihood that she will have trouble conceiving. Were you taking birth control pills after your miscarriage? If so, for how long? The pill can “shut down” your normal cyclic body functions, and often it can take a very long time for the cycle to start again normally. If you are menstruating periodically, then this may be dysfunctional bleeding–that is the bleeding that results after a lack of ovulation. This kind of bleeding usually starts light, gets very heavy, then continues light for a long period. It is not a true period, because there was never a normal ovulation.
You will find it useful to chart your cycles using the Creighton Model NFP charting system. This will allow a doctor trained to interpret these charts to form an opinion about whether you are ovulating occasionally or at all. The doctor may then recommend a targeted hormonal evaluation of the menstrual cycle, which will give you a more definite indication of the exact cause of the problem. A treatment regimen could then be recommended to solve that problem. Perhaps you need hormonal support during your luteal phase. Perhaps you need a medication to stimulate ovulation.
Good luck!
Dr. John Gisla
Why would you not be ovulating? There are a number of possibilities. Are you getting close to “the change of life” (menopause)? As a woman nears menopause (around 40 years old), then often she will begin to skip ovulations. This will result in less frequent periods, and will increase the likelihood that she will have trouble conceiving. Were you taking birth control pills after your miscarriage? If so, for how long? The pill can “shut down” your normal cyclic body functions, and often it can take a very long time for the cycle to start again normally. If you are menstruating periodically, then this may be dysfunctional bleeding–that is the bleeding that results after a lack of ovulation. This kind of bleeding usually starts light, gets very heavy, then continues light for a long period. It is not a true period, because there was never a normal ovulation.
You will find it useful to chart your cycles using the Creighton Model NFP charting system. This will allow a doctor trained to interpret these charts to form an opinion about whether you are ovulating occasionally or at all. The doctor may then recommend a targeted hormonal evaluation of the menstrual cycle, which will give you a more definite indication of the exact cause of the problem. A treatment regimen could then be recommended to solve that problem. Perhaps you need hormonal support during your luteal phase. Perhaps you need a medication to stimulate ovulation.
Good luck!
Dr. John Gisla
Answered By:
John Gisla, MD
Dr. John Gisla, Board Certified by the American Academy of Family Physicians, pracitces in the Sacramento Region.
