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What should I do if my period hasn't started after taking progesterone for 7 days?

Jan 29, 2023 Source: Cainiu Health
Dr. Lv Aiming
Introduction
If menstruation has not occurred after 7 days of progesterone injection, possible causes may include pregnancy, menstrual disorders, or intrauterine adhesions. It is recommended to undergo a color ultrasound examination followed by fasting blood tests for the six sex hormones: luteinizing hormone (LH), follicle-stimulating hormone (FSH), progesterone, estradiol, prolactin, and testosterone. A diagnosis should be made based on the test results. Before receiving progesterone injections, consult your doctor thoroughly regarding relevant precautions.

If menstruation does not occur within 7 days after progesterone injection, possible causes include pregnancy, menstrual disorders, intrauterine adhesions, etc. It is recommended to undergo a color ultrasound examination first, followed by fasting blood tests for the six sex hormones: luteinizing hormone (LH), follicle-stimulating hormone (FSH), progesterone, estradiol, prolactin, and testosterone. Diagnosis should be based on these test results. Before receiving progesterone injections, patients should thoroughly consult their doctor regarding relevant precautions and strictly follow medical advice. Seek prompt medical attention if any discomfort occurs.

1. Pregnancy

If sexual intercourse occurred during the ovulation period without contraception, and menstruation has not started more than 7 days after stopping medication, pregnancy should be considered. It is recommended to visit a hospital for blood HCG testing and pelvic ultrasound. A blood HCG level above 25 mIU/mL or visualization of an intrauterine gestational sac via ultrasound indicates pregnancy. If continuing the pregnancy is intended, appropriate measures for fetal preservation should be taken. If not planning to continue the pregnancy, seek termination services at a qualified medical facility.

2. Menstrual Disorders

Menstrual irregularities caused by other factors—such as excessive stress, anxiety, severe dieting, exercise-induced malnutrition or low body fat, pituitary tumors, ovarian dysfunction, or endometrial damage—may also delay menstruation. In such cases, doctors may prescribe combined estrogen-progestogen therapy to induce menstruation.

3. Intrauterine Adhesions (Asherman's Syndrome)

Intrauterine adhesions often develop following traumatic uterine procedures and are a common complication after induced abortion. Depending on the location and severity of the adhesions, clinical manifestations vary and commonly include amenorrhea, oligomenorrhea, or cyclical abdominal pain. Treatment typically involves hysteroscopic adhesiolysis to separate the adhesions.

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