I had intercourse 25 days back, and I missed my periods. Should I take Mifepristone pills?

Hi,

Welcome to icliniq.com.

Thanks for reaching out. Mifepristone and Misoprostol are hormonal medicines used for termination of pregnancy. If your urine pregnancy test is negative, you should not be taking these medicines. As these are hormonal medicines, there are a lot of unwanted side effects of these medicines. My recommendation is not to take this medicine now on the background of just a missed period and urine pregnancy test negative. Ideally, if your periods do not come next week, you should repeat the urine pregnancy test. I hope this helps you with your query. Feel free to reach out with any further questions.

Hi,

Welcome back to icliniq.com.

It is very unlikely that a urine pregnancy test will be negative if you are pregnant. In that case, you can do a blood beta hCG (human chorionic gonadotropin) test, which will be very confirmatory.

Hi,

Welcome back to icliniq.com.

I went through your query again. Beta HCG levels less than five means the person is not pregnant. In your case, it is two, which means you are not pregnant. So you do not need to take Mifepristone and Misoprostol. There is no pregnancy at this time, so do not stress. If you have not got your periods yet, you should take tablet Meprate or Medroxyprogesterone acetate 10 one tablet twice a day for seven days. Bleeding will occur within five to six days of stopping the pill. I hope this answers your query. Feel free to reach out with any further questions.

Hello,

Welcome back to icliniq.com.

There could be some hormonal disturbances, which could be the reason behind these delayed periods.

Other reasons could be,

1. Stress.

2. A recent lifestyle change.

3. Weight loss.

4. Thyroid disorders.

5. PCOS (polycystic ovarian syndrome).

So you could do some investigations to know the cause behind this,

1. Thyroid function test.
2. Complete blood count.
3. Fasting insulin levels.
4. Random blood sugar.
5. Serum prolactin.
6. Ultrasound pelvis.

The medicines I have prescribed are sufficient but have side effects like bloating, nausea, and breast tenderness. It will have very mild side effects.

Hello,

Welcome back to icliniq.com,

I can understand your concern.

It would be hyperprolactinemia which is mostly causing menstrual disturbances. I advise you to get a pelvis ultrasound and would like to know if you have started Meperate (Medroxyprogesterone acetate) medication.

I hope this information will help you.

Thank you.

Hello,

Welcome back to iclinq.com.

I can understand your concern.

I have reviewed the reports (attachments have been removed to protect the patient's identity) and as blood beta HCG (Beta-Human Chorionic Gonadotropins) and urine beta HCG are negative, it indicates that you are not pregnant. I advise you to repeat blood beta HCG or do an ultrasound as blood beta HCG levels get doubled every two days in pregnancy.

I hope this information will help you.

Thank you.

Hello,

Welcome back to icliniq.com.

I can understand your concern.

Azithromycin and paracetamol do not affect the prolactin levels. Also, there will not be any effect of the last year's typhoid infection on this period of delay. The prolactin levels are only mildly elevated. Some women with borderline elevated prolactin levels can have infertility, menstrual irregularities, nipple discharge, and also breast tenderness. There will not be a chance of prolactin-secreting tumors in your case, as women with prolactin-secreting tumors usually have high prolactin levels and symptoms like visual disturbances, loss of interest in sex, and infertility. I advise you to follow the below-mentioned instructions.

1. Continue taking Cabergoline tablet as advised and it will help in decreasing the prolactin levels.
2. Get an MRI (magnetic resonance imaging) scan to exclude pituitary tumors if in case the prolactin levels do not come down.
3. Stop taking any anti-reflux medicines containing Domperidone (usually combined with pantoprazole), as prolactin levels increase.

Kindly consult a specialist, talk to them, and take the medications with their consent.

Thank you.

Hello,

Glad to have you back at icliniq.com.

I can understand your concern.

The tablets Meperate (Medroxyprogesterone acetate) and Cabergoline act through different mechanisms. I advise you to follow the below-mentioned instructions.

1. Finish Meperate dosage first and start Cabergoline from next week.
2. Take medication at the same time every day for best results.

I hope this information will help you.

Thank you.

Hello,

Welcome back to icliniq.com.

I can understand your concern.

Increased prolactin levels interfere with the release of eggs, and so can affect fertility. But when prolactin levels normalize after treatment with Cabergoline, fertility improves a lot. Regarding the Meperate tablet, it does not affect fertility as you will be taking it for a short period for withdrawal bleeding. I advise you to follow the below-mentioned instructions.

1. Take 0.5mg of Cabergoline tablet twice a week at the same time after food (to prevent nausea) for eight weeks or two months.
2. Repeat the test for prolactin levels after two months.
3. In most cases, prolactin levels come down after eight weeks of treatment with Cabergoline. Also
4. Take 10mg Meperate (Medroxyprogesterone acetate) twice a day for seven days, then stop. It will take around six to eight days for withdrawal bleeding to occur.
5. Kindly consult a specialist, talk to them, and take the medications with their consent.

I hope this information will help you.

Thank you.

Hello,

Welcome back to icliniq.com.

I can understand your concern.

Meperate can be taken before food or after food. Side effects like bloating, mood swings, and mild breast tenderness, and will subside on their own.

I hope this information will help you.

Thank you.

Hello,

Glad to have you back at icliniq.com.

Foul smelling of menstrual bleeding can be normal for a day. But if the foul smell continues for more than two days or if there is crampy lower abdomen pain, I advise you to follow the below-mentioned instructions.

1. Do a high vaginal swab culture and sensitivity test to see if there is any infection.
2. Stop taking the Meperate tablet.

I hope this information will help you.

Thank you.

Hello,

Welcome back to icliniq.com.

I can understand your concern.

I advise you to continue taking Cabergoline tablets for eight weeks to normalize the prolactin levels.

I hope this information will help you.

Thank you.

Hello,

Welcome back to icliniq.com.

I can understand your concern.

Cabergoline causes some gastrointestinal side effects like nausea, vomiting, constipation, or diarrhea in some people. I advise you to follow the below-mentioned instructions.

1. Take Movicol (Polyethylene glycol) sachets, two at night time, or Senna (Cassia senna), twoteaspoons at bedtime with a glass of water. Consume at least 2.5 liters of water every day.
2. Do not stop the tablet Cabergoline and continue it for eight weeks.
3. Kindly consult a specialist, talk to them, and take the medications with their consent.

I hope this information will help you.

Thank you.