Patient's question:
Detailed medical condition and consultation purpose: I had a medication-induced abortion at the hospital on October 4th. At that time, the entire embryo was expelled, and I went home. However, a month has passed, and my period has not arrived. During this time, I have experienced abdominal bloating, pain, and a sensation of heaviness, similar to symptoms of an impending period, but it has not come. On November 19th, I went to the hospital for a check-up, and the doctor diagnosed me with cervical stenosis. That same afternoon, I underwent a cervical dilation procedure. However, when I returned home, the bleeding was only a little and was dark gray in color. I would like to ask how many days after the surgery can I expect my period to return to normal? If my period is normal this month, will there be a risk of stenosis again?Doctor's answer:
Hello: As long as active treatment is pursued, it will not affect future fertility. If you have recently undergone a D&C or D&E procedure and experienced amenorrhea, reduced menstrual flow, or cyclic abdominal pain afterward, it should be suspected that adhesions have occurred in the uterine cavity. During a gynecological examination, the cervix may exhibit cervical motion tenderness, the uterus may be slightly enlarged with tenderness, or there may be no positive findings. Basal body temperature measurement, vaginal smear, or estrogen (E2) in urine or serum sex hormone tests show cyclical changes, indicating normal ovarian ovulation function. However, after treatment with progesterone or artificial cycles, menstruation still does not occur or menstrual flow remains very light. Using a probe to examine the cervix and uterine cavity, the probe may encounter a blockage or difficulty passing through at the internal os of the cervix or at a certain point in the uterine cavity. Hysterosalpingography (HSG) can visualize the location and extent of adhesions. If the cervical canal is adhesed, the contrast medium is retained at the blocked site and cannot enter the uterine cavity; if adhesions are present in the uterine cavity, various types of filling defects can be observed. Hysteroscopy is a relatively new technology that allows direct visualization of the location, distribution, and shape of adhesions, while also enabling treatment, such as adhesiolysis, to restore the normal morphology of the uterine cavity.