When You Skip a Period After Miscarriage

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After a miscarriage, it takes time for your body to fully recover. Your body's readjustment to its pre-pregnancy state can last anywhere from a few weeks to a few months. This recovery period includes resuming menstruation. Most women will have a period within four to six weeks after the pregnancy loss, but for others, it may take as long as two to three months before menstruation returns to normal.

Overview

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, aim to be patient—your body may simply need a little extra time to recover in order to be ready for another pregnancy. However, you don't necessarily need to wait to get your period before you try to conceive.

In many cases, once your levels of human chorionic gonadotropin (hCG), a key hormone that supports pregnancy, return to zero, you can usually safely begin trying to conceive, even if you haven't had your period yet. Below, we look at possible reasons for your period's delay and when to contact your doctor.

Reasons for a Delayed Period

There are multiple reasons for a delay in normal menstruation after a miscarriage, as well as individual variation. Give your body time to heal, but contact your healthcare provider if your period hasn't returned by three months. Something might be going on that needs attention. Here, we examine the most common explanations for why your period may not resume right away.

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 pregnancy loss. You may be pregnant again.

In fact, studies show that women who start trying to conceive in the months right after a miscarriage often have a better chance of doing so than those who wait more than three to six months before beginning to try. Some of these women get pregnant during their first ovulation after the pregnancy loss—without ever menstruating.

It's possible to become pregnant after a miscarriage and before you have a period. Some women do not experience any delay in the return of normal menstrual cycles. In these cases, ovulation may occur as early as two weeks after a miscarriage.

Irregular Cycles

If your menstrual cycle was irregular or tended to be longer than the typical 28 day cycle before getting pregnant, it's possible that the delay is just your body adjusting back into its normal (but longer-than-average) pattern.

A Late-Term Miscarriage

The farther along you were in your pregnancy when you miscarried, the longer it may take for your period to resume. Pregnancy loss in the third trimester can mean your body's hormones may take longer to adjust back to pre-pregnancy levels, which is your body's signal that it's no longer pregnant and can begin ovulating again.

Asherman's Syndrome

A small number of women develop Asherman's syndrome after a dilation and curettage (D&C), a minor surgical procedure to remove tissue from the uterus. In this condition, scars and adhesions form when membranes in the uterus stick together or grow back abnormally after being cut. This complication can interfere with ovulation and obstruct the uterus and cervix.

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 an 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.

Asherman's syndrome is diagnosed with a hysteroscopy, a procedure that involves viewing the inside of the uterus with a camera inserted into the vagina and through the cervix. A specialized type of ultrasound or an X-ray using dye are also sometimes used to visualize scar tissue in the uterus.

The scar tissue or adhesions that characterize Asherman's syndrome can be removed surgically. Sometimes, these adhesions return. The 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.

When to Call Your Doctor

No matter the result of your home pregnancy test, call your gynecologist if it's been over two to three months without getting a period. If you aren't pregnant, there could be an issue from your miscarriage that is preventing menstruation. If you were treated with dilation and curettage, your doctor will want to rule out any possible complications.

A Word From Verywell

In addition to the sadness of pregnancy loss, not getting your period in the weeks after a miscarriage can cause uncertainty and stress. You may worry that your body isn't getting back to normal and wonder if you'll be able to get pregnant again.

Talking to your doctor can help clear up your concerns, let you know what is "normal" for you, and help you make a plan for conception.

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7 Sources
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