Patient's question:
Hello!I had an induced abortion 3 months ago, and due to delayed uterine clearance, I developed pelvic inflammatory disease (PID). It hasn’t fully healed yet, and I still haven’t had my period. I’m very worried. Now, my lower abdomen doesn’t hurt much anymore, but I occasionally feel some pain. My vaginal discharge is abundant and yellow. When I went to the hospital for a check-up, they found mild PID and mild cervical inflammation, but everything else with my uterus is normal. Could you please tell me why I still haven’t had my period, and whether it could lead to infertility?
Doctor's answer:
Hello:After artificial abortion, the ovaries generally recover their ovulation function within 22 days, and menstruation usually returns about one month later. However, some women may experience menstrual disorders such as prolonged periods, irregular cycles, or amenorrhea after artificial abortion. This condition typically normalizes within 2-3 months, but in some cases, it may persist for longer.
The following are possible reasons for menstrual disorders after artificial abortion:
(1) The occurrence of menstruation in women is the result of the interaction between the cerebral cortex, hypothalamus, pituitary gland, ovaries, and uterus, regulated by the endocrine system. When a person is under excessive stress, fear, sadness, overexertion, or undergoes surgery, these factors can suppress the function of the hypothalamus, pituitary gland, ovaries, and uterus through the neuroendocrine system, leading to menstrual abnormalities.
(2) After artificial abortion, the sudden disappearance of placental human chorionic gonadotropin (hCG) causes the ovaries to temporarily fail to respond to gonadotropin secreted by the anterior pituitary gland, which may also result in menstrual disorders.
(3) During the artificial abortion process, excessive damage to the basal layer of the endometrium may prevent its regeneration, leading to long-term amenorrhea in patients.
As a result, there is a possibility of infertility. It is recommended to undergo a comprehensive gynecological examination at a hospital to determine the cause before undergoing treatment for menstrual regulation.