What could be the reason for not having menstruation after appendectomy?

　　The absence of menstruation after appendectomy may be caused by postoperative stress response, inadequate nutrient intake, polycystic ovary syndrome (PCOS), hyperprolactinemia, endometritis, etc. It can be improved through emotional regulation, nutritional supplementation, medication, and lifestyle adjustments. If menstruation is delayed for more than one month or accompanied by abdominal pain or abnormal bleeding, prompt medical attention is necessary.

　　1. Postoperative stress response: Surgical trauma, pain, and psychological stress during the recovery period can affect the function of the hypothalamic-pituitary-ovarian axis, leading to hormonal imbalances and subsequently disrupting the menstrual cycle. This may be accompanied by anxiety and poor sleep. It is recommended to relieve stress through listening to music, communicating with family members, ensuring adequate rest, allowing the body to gradually adapt to the postoperative state, and promoting hormonal recovery.

　　2. Inadequate nutrient intake: Poor appetite or deliberate dietary restriction after surgery may lead to insufficient intake of nutrients such as protein and vitamins, which can impair endometrial repair and hormone synthesis, resulting in delayed or absent menstruation. Symptoms may include fatigue and pallor. It is advised to adjust the diet by increasing consumption of lean meat, eggs, vegetables, and other nutritious foods. When necessary, nutritional supplements should be taken under medical guidance to meet the body's recovery needs.

　　3. Polycystic ovary syndrome (PCOS): Elevated androgen levels and insulin resistance can cause ovulatory dysfunction, leading to infrequent menstruation or amenorrhea. Symptoms may include hirsutism, acne, and weight gain. Patients may take medications such as dydrogesterone tablets, ethinylestradiol cyproterone acetate tablets, or metformin hydrochloride sustained-release tablets under medical supervision to improve symptoms.

　　4. Hyperprolactinemia: Abnormal pituitary function or medication effects may elevate prolactin levels, suppressing ovulation and estrogen secretion, thereby causing delayed menstruation or amenorrhea. Symptoms may include galactorrhea and headaches. Treatment may include medications such as bromocriptine mesylate tablets, vitamin B6 tablets, or cabergoline tablets, used under medical guidance.

　　5. Endometritis: Bacterial infection of the endometrium due to poor hygiene after surgery can trigger inflammation, interfering with normal endometrial proliferation and shedding, leading to menstrual irregularities. This may be accompanied by lower abdominal pain and increased vaginal discharge. Symptoms should be managed with antibiotics such as cefuroxime axetil tablets, metronidazole tablets, or levofloxacin hydrochloride capsules as prescribed by a physician.

　　For daily care, maintain good external genital hygiene, change underwear regularly, follow a regular sleep schedule avoiding late nights, engage in gentle physical activities such as walking, and maintain a positive mindset to support both physical recovery and normalization of the menstrual cycle.