|Discussion in 'All Categories' started by shipra - May 2nd, 2014 2:45 pm.|
I delivered my second baby also via c section in 2010.My bleeding was more so they did a d&c on third day of my delivery.After three months I had a green discharge so again they did a d&c following which i never had my periods .Before that also my periods were irregular but now since four years I don't have any periods at all.
Sometimes I have menstrual cramps but no bleeding.I am 33.Please advice
re: no menses by Dr.J S Chowhan - May 5th, 2014 3:06 am
Dr.J S Chowhan
The cavity of the uterus is lined by the endometrium. This lining is composed of two layers, the functional layer (adjacent to the uterine cavity) which is shed during menstruation and an underlying basal layer (adjacent to the myometrium), which is necessary for regenerating the functional layer. Trauma to the basal layer, typically after a dilation and curettage (D&C) performed after a miscarriage, or delivery, or for medical abortion, can lead to the development of intrauterine scars resulting in adhesions that can obliterate the cavity to varying degrees. In the extreme, the whole cavity can be scarred and occluded. Even with relatively few scars, the endometrium may fail to respond to estrogen. Often, patients experience secondary menstrual irregularities characterized by a decrease in flow and duration of bleeding (amenorrhea, hypomenorrhea, or oligomenorrhea) and become infertile. Menstrual anomalies are often but not always correlated with severity: adhesions restricted to only the cervix or lower uterus may block menstruation. Pain during menstruation and ovulation is sometimes experienced and can be attributed to blockages. It has been reported that 88% of AS cases occur after a D&C is performed on a recently pregnant uterus, following a missed or incomplete miscarriage, birth, or during an elective termination (abortion) to remove retained products of conception.Diagnostic Hysteroscopy can diagnose the problem.You can send your latest reports of FSH,LH,Serum Insulin and S.Prolactin for further advice.
Dr J S Chowhan
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