Treatment of drug-induced amenorrhea

Surveys show that amenorrhea is more often caused by long-acting contraceptives than short-acting oral contraceptives. Amenorrhea is also more common in sustained-release contraceptive systems, such as subcutaneous implants and intrauterine sustained-release contraceptive devices (such as Mi Yue Shou). Many women can return to normal menstruation after stopping these contraceptive measures. However, some women still do not see menstruation within 2-3 months or even 6 months after stopping the medication. In this case, some treatment is needed.

(1) If menstruation cannot be resumed after stopping the drug, 20 mg of progesterone can be injected intramuscularly for 3-5 consecutive days, or 6-10 mg of medroxyprogesterone can be taken orally per day for 10 consecutive days, and the bleeding can be withdrawn after stopping the drug.

(2) If there is no bleeding after taking progesterone, estrogen and progesterone can be used sequentially. Bleeding should occur more than one week after stopping the medication. It is best to use it for three consecutive cycles.

(3) Starting from the 5th day after blood withdrawal, clomiphene 50 mg/day can be used for 5 consecutive days to promote the recovery of ovulation.

(4) For those whose menstruation cannot be restored after taking long-acting oral contraceptives, short-acting oral contraceptives can be used for cyclical treatment. One course of treatment is 3 months, and menstruation can usually be restored.

(5) Amenorrhea caused by the sustained-release contraceptive system is a normal reaction, harmless to health, and does not require treatment. Menstruation will resume naturally after removal. If amenorrhea is unacceptable, ethinyl estradiol can be added as appropriate, 10 mg/day, for 20 days. There will be withdrawal bleeding after stopping the drug.