Q. I am late for my periods by 19 days with negative pregnancy tests. What to do?

Answered by
Dr. Sravanthi Nuthalapati
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Nov 12, 2020 and last reviewed on: Nov 28, 2020

Hello doctor,

I have PCOD. And I am having Metformin and Apcod. But a year ago, I left using it; since then, I have been regular on my periods. Recently I got married three months ago, and we have not been using any protection. I am late for my periods by 19 days and two negative pregnancy tests. Due to the pandemic, I am not able to visit any hospital. Please help.



Welcome to icliniq.com.

Please do not worry, as this can be sorted out. The first thing is that you need to reduce your weight to get your periods regularly without any medications spontaneously. Because PCOS (polycystic ovarian syndrome) is a lifestyle-related problem, it is the weight gain that leads to the hormonal disturbances, causing the symptoms. Also, I would say you should continue retaking your Metformin tablets as they affect regulating your insulin level because the development of insulin resistance is the main culprit for the hormonal disturbances in PCOS.

I have the medications to be taken to get your periods, as the pregnancy tests have been negative twice. Please get the blood tests done as advised below once you get your periods on the second or third periods. Meanwhile, try to reduce your weight, do regular exercise, and maintain an excellent strict diet and avoid a sedentary lifestyle. I hope this helps you.

Investigations to be done:

-Complete hemogram.
-Lipid profile.
-LFT (liver function test), or RFT (renal function test).
-75 g Glucose tolerance Test (Fasting, one hour, and two hours).
- HbA1c (glycated hemoglobin) level,
-Serum calcium, Vitamin D, and B12 levels.
-Serum fasting and postprandial Insulin levels.
-Serum FSH (follicle-stimulating hormone), LH (luteinizing hormone), free testosterone, Estradiol, Prolactin levels, thyroid profile (T3 (triiodothyronine), T4 (thyroxine), TSH (thyroid-stimulating hormone), Anti TPO (thyroid peroxidase)) on the second or third day of the next menstrual period.

Probable diagnosis:

PCOS and weight gain.

Treatment plan:

- Recheck urine pregnancy test if negative then take,
- Tablet Meprate or Deviry (Medroxyprogesterone) 10 mg twice daily after food for five days.
- Wait for withdrawal bleed in the next seven to ten days.
- To get the blood tests on day two or day three menses.

Preventive measures:

-Reduce weight.
-Maintain a menstrual diary.
-Regular exercises at least one hour daily.
-Lifestyle and dietary modifications (Consult a dietician if possible).

Regarding follow up:

- Follow-up with the reports.

Hello doctor,

Thanks for your reply.

I agree with all you say. But I have been very active, and my periods have stopped all of a sudden. What if I am pregnant? If I take tablets to get my periods, might it be at risk? Also, I am in a red zone area; I cannot go to the hospital now as it is risky.



Welcome back to icliniq.com.

So yeah, even if you are very active, your excess weight contributes to your hormonal disturbance and dietary factors. And yeah, regarding your pregnancy, as the pregnancy test is negative, it implies you are not pregnant at the moment. That is why I asked you to recheck your urine pregnancy test before starting the medications. If you get pregnant despite taking this medication, you do not worry about it; you will not get your periods. Only if you are not pregnant, then only this medication will give you withdrawal periods. I hope this answers your doubt.

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