The title of this post is something I googled over and over again (and continue to google) five and a half months now after my miscarriage. Why is my cycle still irregular after my miscarriage almost 6 months ago? And the lack of information out there is so frustrating that I finally decided to simply write this post myself.
Here is what I did find when I searched it: It might take your cycle a couple months to get back to normal. Normal. Your first couple of periods might be a little odd — like heavier or lighter. Normal. Your cycle might be a little irregular for a few months. Normal.
But I couldn’t find anything about what to do in the situation I have found myself in: Month after month, my period appears to return to normal. And my cycle even seems back to its normal length. Then my period stops, like normal. And I breathe a sigh of relief, thinking that it’s finally back to normal after five cycles. But then, another day later after having had no bleeding for a day: Another day or two of bleeding. Odd cramping, after my bleeding is over. Not to mention: My ovulation tests having shown a normal peak for maybe a month or two in the five or six cycles I’ve tested since my miscarriage. For the other months, no sign from my body that I am even ovulating; a debateable peak on my ovulation test. What is going on? Is this really normal after this many months?
In sifting through what little I could find online, I did find a couple of possible causes. But first, some background:
[Disclaimer: I am not a doctor or medical practitioner. Any medical information is strictly my opinion based on research and personal experience, and not to be taken as advice. Always seek the advice of a licensed physician for your medical needs. Read my full disclaimer here.]
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My Missed Miscarriage
I wrote about my missed miscarriage (at 10.5 weeks) in this post here. I had a seemingly uncomplicated miscarriage, passing the baby naturally and then taking some misoprostol vaginally at my doctor’s suggestion when she couldn’t be 100% sure that everything had passed (against my better judgement, but that’s a story for a different post).
The bleeding or spotting from my miscarriage lasted about two weeks. I got my period 4.5 weeks after the start of my miscarriage bleeding. I had gotten a strong positive ovulation test a couple of weeks after my miscarriage, but we decided not to try for a pregnancy that cycle — again, at my doctor’s suggestion that I wait at least until my HCG levels were below 5. (Not to mention, even though I got a positive ovulation test, I was still spotting slightly.)
That first period after miscarriage was longer than normal, as expected — about a week. And I experienced the irregular bleeding where it stopped for a day and then started again. That cycle I appeared to barely have a peak LH surge (did I ovulate?) and didn’t notice any signs from my body that I was ovulating.
Again, I figured my first period would be odd. When the second one was the same story, I assumed my body was still getting back to normal. By the third period, though, I started to think that maybe something was wrong. I contacted my doctor, and she did an ultrasound.
Ultrasound results
When I met with my doctor immediately after my ultrasound, she assured me that everything looked normal. She prescribed me a short dosage of progesterone, telling me that sometimes it can help reset your cycle.
In the midst of taking this medication, I got a message from my doctor: The ultrasound report actually did find “a small irregularity in my endometrial lining.” It was so subtle that my doctor didn’t recommend any intervention, but did suggest another ultrasound and follow-up in 3 months. At this point I was hoping the progesterone would take care of things anyway.
But two months later, here I am at the same point, experiencing the same odd periods. I contacted my doctor again, and this time she scheduled me for an earlier appointment with an ultrasound, and automatically scheduled me for a D+C a month later (pending ultrasound findings, but it appears there is probably something going on with my irregular bleeding).
So now, if you’re finding yourself in the same boat I am (if you are, please comment!), on to the possibilities:
Why is my cycle still irregular after miscarriage?
Although this is likely not an exhaustive list, here are five possible reasons I found during my research of why your cycle is still irregular after miscarriage…even if it’s been months, like it is for me:
1. Polyp(s)
This is what my doctor thought could be a potential cause of the “slight irregularity” in my endometrial lining. And, in doing a little research, I found that abnormal bleeding is the most common symptom of a polyp. Although very rarely cancerous, large or numerous polyps can play a role in infertility and miscarriage. (This doesn’t seem to be the case for me, as I may or may not even have one visualized on the ultrasound.)
2. Endometritis
Another possibility is endometritis (not to be confused with endometriosis). This is a bacterial infection that causes inflammation of the uterus — and occurs most often after childbirth or miscarriage. Endometritis can be diagnosed by taking a biopsy of uterine tissue or by doing a hysteroscopy. My doctor said that in addition to the D+C I have scheduled, she would also take a biopsy to check for infection. Most likely, however, endometritis would have other symptoms (like fever, pain, or swelling) besides just slight irregular bleeding.
3. RPOC — Retained products of conception
I’m including this only because you might be researching this without having really been monitored by your OB for decreasing HCG levels. When HCG levels get below 5, doctors consider you to no longer be pregnant, or to not have any products of conception left. So if you’re like me and were monitored until they went below 5, having retained products of conception seems HIGHLY unlikely. (That said, I did find one random study where a woman was found to have no pregnancy hormones but did have fetal tissue, so it’s technically possible…but again, seems like a one in a million chance.)
4. The miscarriage caused a change in bleeding pattern
My OB did mention that it is possible for my bleeding pattern to have just changed since my miscarriage. I can’t seem to find any research-based reasons for this, but I decided I’d at least mention it. More likely, I think —
5. You need to give your body even more time to heal
I find this one hard to believe, given that it’s been over five months since my miscarriage. BUT I suppose it’s possible. My ovulation seems to be all over the place still, and even my cycle length isn’t quite as predictable. Maybe, as much as I hate to say this is even a possibility, I still just need to give my body more time.
*Note: I published this post in Oct, but I actually wrote this post six months post-miscarriage around Feb.
Update: Turns out the reason my cycle was still irregular after miscarriage came down to #5 for me. Shortly after writing this post — six months after my miscarriage — I decided to cancel that D+C that was scheduled, as my bleeding seemed to be just about back to normal. And then I found out I was pregnant that very cycle. Read my update here.
