How to regularize periods post abortion? – Dr. Sheela B S

Periods after abortion returns fairly quickly in majority of the patients. But in some of the patients it may get delayed for several weeks to months but in majority of the women they are very much concerned about their cycles. The normal regular cycles they feel that it gives an assurance to a woman that her reproductive system is very much normal.so post abortion it becomes very much regular, there are many reasons for this. Let us starts one by one. In early pregnancy, the development of the fetus is very small, but the body has produced in abundance hormones. So these hormones gets retained in the body for several weeks after the abortion. This hormones will supress the ovulation in turn will delay the menstrual cycle. So this is one of the major reason. The next is the abortion process is itself very stressful for the women. So the decision to take to have an abortion is very painful and there is lot of guilt in her, so because of this kind of stress can have an impact on the woman and this inturn will have an effect on the menstrual cycle and one more thing is the period at which the abortion takes place is also very important. If the abortion takes place in the first trimester that is the early pregnancy, the following cycles will be returning fairly quickly but the type of abortion which the patient undergoes is also very important, that is medical abortion or surgical abortion in the first trimester. So post medical abortion the first cycle which they get will be heavier than the normal, but post the surgical abortion, the cycles happen at regular interval, but the cycle is very scanty, and the flow is very minimal. If the patient is already a case of PCOD before her abortion her cycle may be irregular as before, so accordingly the patient has to be treated. So how the patient has to be treated post abortion for her cycles to be normal. Number one is the day of abortion itself she has to start with her contraceptive pill it will not only regularise the cycles, it will also protect them against conception of future pregnancies and also it will reduce the flow during the next cycle so that the blood loss is also avoided. The next thing is if unusual delay is there, if it is prolonged after 8 weeks, first one has to rule out is the pregnancy because the ovulation can happen as early as 15 days post abortion so they can always conceive the very next cycle. So pregnancy has to be ruled out. After ruling out pregnancy if the periods are still delayed, one can start withdrawal flow by starting with progesterone tablets for 3 days, that is primolut twice daily for three days and another cause is PCOD. If the patient who already has PCOD her cycles gets delayed invariably in such patients PCOD management has to be started right form weight management, with the correction of her diet and cyclical regularisation by medications. So one thing one has to understand here is post abortion is a stressful factor but a woman is always concerned about her future pregnancies and the complications that are associated with. So a woman should be assured that abortion by itself will not cause any health hazard as such because abortion has become a very safe event nowadays and it will not interfere with her future fertility and it may not cause any complication during her next pregnancy.