I am a 42-year-old lady and have been using injectable contraceptives for the past 10 years. When I was using the injections, I would go for months without experiencing menses. Even when they occurred, the flow would be very light.
I stopped using them one year ago but my menstrual cycle is still not normal. This is highly frustrating because I am trying to conceive.
Has the long usage of contraceptives messed up my reproductive system? How can I get my periods back to normal again? Is there medication I can take?
Injectable contraceptives are some of the most effective forms of hormonal family planning methods available in the market. They work on your reproductive cycle resulting in lack of regular ovulation (releasing of the egg/ova from the ovaries).
Ultimately, the interruption of the normal cycle results in irregular (often infrequent) menses. Most women, just like yourself, can go for months without experiencing their period.
Return to normal
Unlike oral contraceptive tablets where fertility and normal menstrual pattern is restored within a month or two after cessation, injectable contraceptives take much longer. In some cases, it can take up to 18 months before the menstrual cycle is back to normal.
Irregular periods doesn’t mean you are infertile
Women who have irregular periods can also conceive. How often you get your periods is not a sign of fertility.
Fertility in a woman is determined by the release of healthy ova/eggs from your ovaries and the ability of the ova to travel down the fallopian tubes and implant on your womb once it is fertilised.
If your body is producing healthy ova and you have a healthy reproductive system, you can still conceive despite the irregular periods.
Contraception does not damage your reproductive system
Hormonal contraception (whether injectable, tablets or patches), does not damage your reproductive system. The effects are temporary and will not harm your body.
Give yourself time not medication
Once you cease using injectable hormonal contraception, you need to give your body time to return to normal. Often, there is no need to take medication.
There are several drugs in the market (often sold over the counter and via newspaper classifieds) that claim to restore one’s menstrual cycle to normal.
Avoid taking these medications/herbs as most have not been regulated by the Kenya Pharmacy and Poisons Board and can be harmful.
One is only considered to be having problems with fertility if they have tried to conceive for over one year with no success.
If you are concerned about your fertility, go for a review by your gynaecologists. There could be several factors contributing to your challenges with conception.
Your doctor will be able to review these with you and determine if something is wrong. If you have a partner, go with them because fertility is ‘couples’ problem (not an individual’s problem) and so, both of you will need to be assessed.
My 16-year-old daughter started menstruating two years ago. Her periods, however, have been irregular – sometimes, even going for a month or two without experiencing them. Is this normal? Does this mean that she has problems with her ovaries or uterus?
A: Irregular periods is a common problem amongst teenagers especially during the first year or two after onset. Often, this is not a cause for concern as most girls will go on to develop a regular cycle as they mature.
Cycles are not the same
When most of us were taught about menstruation, we were told that a normal period should last three to five days and it should happen every 28 days. However, every woman’s cycle is different. Periods can last anything from one to eight days. The time between one period and another can range from 21 to 35 days. This means that a woman can get two periods in one month (if they occur every 21 days) or she can skip a month between periods (if they occur every 35 days).
Irregular periods can be a sign of a health problem
In some cases, irregular periods can be a sign of an underlying health issue.
• Reproductive hormone imbalance
• Polycystic ovarian disease
• Thyroid problems
• Extreme diet and exercise programmes
• Drastic weight loss
In your daughter’s case, it would be in her best interest to go for a review by a gynaecologist. If there is anything of concern, he/she should be able to do necessary tests and scans.
Your daughter needs to keep a ‘period diary’. She should keep this for about six months prior to her review by the doctor.
This will help the gynaecologist determine if she has irregular periods or not and whether she requires further investigation.