Why doesn’t menstruation come after more than 40 days after abortion?

The absence of menstruation for more than 40 days after abortion may be related to factors such as delayed endometrial repair, endocrine disorders, intrauterine adhesions, residual pregnancy tissue, and delayed recovery of ovarian function. It is recommended to seek medical examination in time and deal with it in a targeted manner after the cause is clarified.

1. Delayed endometrial repair

Abortion surgery can cause damage to the endometrium, which will take some time to repair. Under normal circumstances, endometrial repair takes 15-30 days. In some patients, the repair time may be extended to more than 40 days due to physical differences or greater surgical trauma. This condition usually does not require special treatment, just rest and avoid strenuous exercise.

2. Endocrine disorders

Hormone levels in the body change significantly during pregnancy, and it takes time for hormone levels to return to balance after abortion. If the hypothalamic-pituitary-ovarian axis function is dysfunctional, it may lead to delayed menstruation. This condition may be accompanied by symptoms such as breast swelling and pain, mood swings, etc. It needs to be diagnosed through hormone testing, and if necessary, progesterone capsules and other drugs can be used under the guidance of a doctor to regulate it.

3. Uterine adhesions

Surgical operations may damage the basal layer of the endometrium, leading to adhesions on the front and back walls of the uterine cavity, manifesting as scanty menstruation or amenorrhea. This condition is often accompanied by periodic lower abdominal pain and needs to be confirmed by hysteroscopy. Mild adhesions can be separated under hysteroscopy, and an intrauterine device can be placed after surgery or estradiol valerate tablets can be used to prevent recurrence of adhesions.

4. Pregnancy tissue residues

Abortion surgery does not completely remove the pregnancy tissue, and the remaining tissue affects uterine contraction and endometrial repair, resulting in missed menstruation. This condition may be accompanied by symptoms such as irregular vaginal bleeding and dull pain in the lower abdomen, and ultrasound examination can confirm the diagnosis. After diagnosis, uterine curettage is required, and motherwort granules can be used to promote uterine recovery after surgery.

5. Delayed recovery of ovarian function

In some patients, the ovarian ovulation function recovers slowly after surgery, resulting in prolonged menstrual cycles. This condition is mostly transient and usually resolves on its own after 1-2 menstrual cycles. If anovulation persists, you may need to use drugs such as clomiphene citrate capsules to induce ovulation.

After abortion, you should pay attention to keeping the perineum clean. Bath bathing and sexual intercourse are prohibited within 1 month after the operation to avoid infection. Eat more high-quality protein and iron-rich foods such as lean meat, animal liver, etc. to help your body recover. Carry out light exercise such as walking appropriately and avoid strenuous exercise. Keep a regular schedule and avoid staying up late. If you still have no menstruation after more than 2 months, or if you have abnormal symptoms such as abdominal pain or fever, you should seek medical examination immediately. A follow-up ultrasound is required 1 month after the operation to understand the recovery of the uterus. Stay relaxed mentally and avoid excessive anxiety that affects endocrine regulation.