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Infertility

Provera and Missed Period

09/18/2008

Question:

I missed my period and took several pregnancy tests, which were all negative. My MD did an internal and also found no pregnancy. He prescribed the Provera tablets after I menstruated, this was very painful and heavy and is going on now for 3 weeks. How long is the bleeding expected to go on for?

Answer:

Typically, following Provera, menses should be relatively normal (i.e. usually not longer than 7 days).  Clearly, this is much longer than normal.  You should have blood testing performed, including a thyroid test as well as other hormones such as prolactin.  You indicated that you had a normal "internal exam".  I am not sure whether this means that you had a pelvic ultrasound, but I would recommend that you have an ultrasound with injection of a small amount of saline into your uterine cavity.  This would determine whether your bleeding is caused by a polyp or fibroid inside the uterine cavity.  The ultrasound would determine whether you have fibroids in the wall of the uterus.  If you are over 35 y/o, I would consider doing an endometrial biopsy to rule out abnormal cells of the uterine lining as a cause of the bleeding.  I would suggest that you follow up with your physician.

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Response by:

Daniel B Williams, MD Daniel B Williams, MD
Formerly:
College of Medicine
University of Cincinnati