When You Skip a Period After Miscarriage

After a miscarriage, it can take time for your body to fully recover. This includes resuming menstruation. Most women will have a period within four to six weeks after the loss of a pregnancy, but it may take as long as two to three months before menstruation returns to normal.

For someone who's eager to begin trying to conceive again, the wait for a regular cycle can be frustrating. If you're in this situation, try to be patient with your body—it may simply need a little extra time to recover in order to be ready for another pregnancy.

If it's been longer than a couple of months since your miscarriage and you haven't had a period yet, consider taking a home pregnancy test if you've been having sex without using birth control since your miscarriage. It's possible to become pregnant immediately after a miscarriage and before you have a period. Some women do not experience any delay in the return of normal menstrual cycles, and thus, ovulation may occur as early as two weeks after a miscarriage.

Either way, call your gynecologist. If you aren't pregnant, it's unlikely anything serious is going on. However, a small number of women who have a miscarriage and are treated with a procedure called dilation and curettage (D&C), in which a surgical instrument is used to remove tissue from the uterus, develop Asherman's syndrome. In this condition, scars and adhesions form when membranes in the uterus stick together or grow back abnormally after being cut and can interfere with ovulation and obstruct the uterus and cervix.

Although Asherman's syndrome is most commonly a complication of a D&C, especially when the retained products of conception become infected, it also can result from a cesarean section, a D&C performed as part of abortion, or a myomectomy, which is surgery to clear the uterus of fibroids.

Signs of Asherman's syndrome include lack of menstrual periods, cramping but little or no bleeding at the time of an expected period, trouble getting pregnant, and recurrent miscarriages.

The best way to diagnose Asherman's syndrome, though, is by means of hysteroscopy performed by an OB-GYN. According to the American College of Obstetrics and Gynecology, for this procedure, a thin, lighted telescope-like device is inserted into the vagina and through the cervix into the uterus. From there it transmits images of the inside of the uterus onto a screen. Specialized ultrasound and x-ray using dye also sometimes are used to visualize scar tissue in the uterus and thus diagnose Asherman's syndrome.

The scar tissue or adhesions that characterize Asherman's syndrome can be removed surgically. Sometimes, these adhesions return; this return of adhesions can possibly be prevented with the administration of hormones (estrogen). Many women who have adhesions removed for the treatment of Asherman's syndrome become fertile again.