What should I do if my period hasn't started 9 days after finishing progesterone? What could be the reason?

In general, if menstruation has not occurred 9 days after finishing progesterone, it may be due to excessive mental stress, pregnancy, cervical adhesion, polycystic ovary syndrome (PCOS), tuberculosis, or other causes. Patients can receive symptomatic treatment based on the specific underlying cause. The detailed analysis is as follows:

1. Excessive Mental Stress

Significant psychological stress can disrupt the hypothalamic-pituitary-ovarian (HPO) axis, which is a key system regulating the menstrual cycle. This disruption may lead to hormonal imbalances, resulting in irregular or delayed menstruation. It is recommended to communicate more with others and reduce mental stress.

2. Pregnancy

Pregnancy is one of the most common reasons for missed menstruation. Progesterone is a hormone produced by the ovaries after ovulation, and it helps maintain the stability of the endometrial lining in the later phase of the menstrual cycle. If conception occurs successfully, continued progesterone secretion maintains the endometrium to support embryo implantation and development. This is a normal physiological process and does not require special treatment.

3. Cervical Adhesion

Mechanical injury, chemical irritation, or pathogen infection may damage the cervical mucosa, leading to cervical adhesion. As a result, the endometrial tissue cannot shed and discharge properly from the body, causing the aforementioned symptoms. Patients should promptly visit a qualified medical institution and undergo surgical treatment such as cervical adhesion separation.

4. Polycystic Ovary Syndrome (PCOS)

The exact cause of PCOS remains unclear but may be related to genetic factors. Patients often experience excessive production of androgens in the ovaries, which interferes with normal formation and shedding of the endometrium, leading to amenorrhea. Patients may take medications such as dexamethasone acetate tablets or spironolactone tablets under medical supervision.

5. Tuberculosis

Tuberculosis is a serious infectious disease that can directly or indirectly affect multiple body systems. It may place the body in a suboptimal health state and impair the normal function of the endocrine system. This can lead to hormonal imbalances, including abnormal progesterone secretion, thereby disrupting the menstrual cycle. Patients can be treated with medications such as isoniazid tablets and rifampicin tablets under a doctor's guidance.

In addition, failure to menstruate 9 days after completing progesterone may also be caused by pituitary adenoma, and prompt medical evaluation and treatment are recommended.