Patient's question:
Detailed medical condition and consultation purpose: Hello, I once took emergency contraceptive pills continuously with my husband within a week. Now, my period hasn't come for two months. In the past, I also experienced irregular menstruation. When I went to the hospital for a check-up, they confirmed I wasn't pregnant. I received six injections of 22ml progesterone, but it still hasn't worked. What should I do now?Doctor's answer:
Long-term use of birth control pills can lead to endocrine disorders, which may also cause delayed menstruation. According to feedback from patients, doctors have also found that a new generation of gastric motility drugs, metoclopramide (also known as domperidone), may also cause this issue. Since metoclopramide does not easily cross the blood-brain barrier, it is believed to have no inhibitory effect on central dopamine receptors. When central dopamine receptors are inhibited, the amount of hypothalamic releasing factors entering the anterior lobe of the pituitary gland decreases, leading to a reduction in the secretion of gonadotropins and corticotropin from the anterior lobe of the pituitary gland, which in turn causes menopause and delayed ovulation. If menstruation is delayed only occasionally 1—2 times and without other accompanying symptoms, it does not fall under the category of menstrual disorders. When the menstrual cycle interval exceeds 35 days, it is referred to as oligomenorrhea, and when menopause lasts for more than 3 menstrual cycles, it is called amenorrhea. After amenorrhea, ovulation does not occur, which can lead to issues such as osteoporosis and endometrial hyperplasia, and must be taken seriously. It is necessary to go to the hospital immediately for a comprehensive examination.