Is the pill causing my irregular periods?
Dear Dr Mitchell,
I got pregnant last year while on Minigynon 30 and subsequently had a miscarriage during the third month. After doing the D&C, I went back on the pills and had regular periods during the first two months, then the following two months I had only mild cramps and brown spotting which only lasted for two days max instead of a regular period. Could the pills be the cause, or could I have PCOS?
It is not unusual for the menstrual flow to be very light, or even absent, once you go on the oral contraceptive pills. This is considered one of the advantages of the birth control pills since the reduced menstrual blood loss reduces the risk of anaemia.
Polycystic ovarian disease syndrome (PCOS) is a hormonal imbalance which causes irregular, absent or scanty menstrual periods. Patients with this condition tend to be: (1) overweight (2) have excessive hair growth on the body (face, chest and abdomen) (3) have acne (4) insulin resistance, and a tendency towards developing diabetes mellitus.
The hormonal imbalance also causes infertility since patients tend not to ovulate. You seem to be quite fertile since you conceived while on the oral contraceptive pill, so it is most unlikely that you have polycystic ovarian disease.
What you can do is to discontinue the oral contraceptive pills for one to two months and use the condom as a back-up method. If the scanty period is due to the pills, then cycles should return to normal when you are off the pills. If the menstrual flow is still absent or very light, then an ultrasound or x-ray of the uterus (Hysterosalpingogram – HSG) should be done to determine if there is scarring of the lining of the uterus from the dilatation and curettage.
This condition is called Asherman’s Syndrome. This causes scanty or no periods and subsequent infertility. This can be treated with good outcome in some patients. However, despite treatment, it can result in recurrent pregnancy losses or premature labour.
Consult your gynaecologist who will advise you further.
Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions and comments via e-mail to allwoman@jamaicaobserver.com or fax to 968-2025. We regret that we cannot supply personal answers.
