What is a Menstrual Inducer: What Is It and What Does It Do?

Menstrual delay can be a common issue experienced by women during certain periods.

Menstrual delay can be a common issue experienced by women during certain periods. This delay can occur due to pregnancy, but it can also be related to health problems. However, this delay does not always mean that there is a problem. Short-term delays can also occur due to factors such as seasonal changes and stress. A delay that persists for a significant period is considered a situation that needs to be addressed. To induce menstruation, a menstrual inducer may need to be prescribed. These medications, which help regulate menstrual cycles, are prescribed by a doctor for regular use over a period of time.

What is a Menstrual Inducer?

If menstrual delay is not due to pregnancy, it may be caused by hormonal imbalances. Sometimes, a body weight that is below what it should be or issues like polycystic ovary syndrome can lead to delays in the menstrual period. Menstrual delay can also cause discomforting symptoms, particularly in the form of bloating and edema. Menstrual delays that are not caused by a medical condition can be alleviated through medications. Menstrual inducers are drugs that contain hormones similar to the progesterone hormone naturally produced by the body, thus helping to induce menstruation. They are also prescribed to women who are not pregnant and have not yet reached menopause, to help normalize their menstrual periods. Therefore, they may be preferred for individuals who have not had their period for a while. The purpose of menstrual inducers is to ensure that individuals experiencing menstrual delay are able to menstruate.

The menstrual period usually occurs at intervals of 28-38 days. An extension of this period, in the absence of pregnancy, is referred to as menstrual delay. This situation can be limited to just a few days but can sometimes last for months. However, if menstruation does not occur within the expected timeframe, a doctor should be consulted to prevent the extension of this period. Issues that may occur alongside menstrual delay include:

• Worsening headaches
• Nausea
• Vomiting
• Fever
• Hair loss
• Milk production

What Causes Menstrual Bleeding to Be Delayed?

There are various reasons for menstrual delay other than pregnancy. This delay can occur due to serious medical conditions or temporary issues. When menstruation is not regular, the production of progesterone hormone in the body does not increase as it should, preventing the shedding of the endometrial lining. As a result, the endometrium can thicken, leading to cyst formation or cancer.

Stress
One of the biggest issues that can affect the menstrual cycle in daily life is stress. Daily routines that can change due to stress and the functioning of the hypothalamus, which closely affects the menstrual period, are major causes of menstrual irregularities. Additionally, weight changes caused by stress can also impact the menstrual cycle.

Weight Problems
Eating disorders like anorexia nervosa or having a body weight that is too low can lead to short or long-term inability to menstruate. This is because the body may halt ovulation due to inadequate body weight. Not only low body weight, but obesity can also lead to hormonal changes in the body. Excess estrogen produced due to obesity can cause delays in menstrual periods and even prevent menstruation altogether.

Polycystic Ovary Syndrome (PCOS)
PCOS causes the body to produce excess male hormones, leading to ovarian cysts. These cysts can cause ovulation irregularities, paving the way for delays in menstrual periods. Additionally, irregularities in insulin hormone levels can occur due to PCOS, and insulin resistance may also contribute to the problem of PCOS.

Birth Control Pills
When birth control pills are used, the levels of estrogen and progesterone hormones in the body can change. Upon stopping the pills, issues such as menstrual irregularities and inability to menstruate may arise.

Chronic Diseases
Chronic diseases such as celiac disease and diabetes can affect the menstrual cycle. Other chronic issues that can lead to menstrual irregularities include Cushing's syndrome, which develops due to excessive cortisol hormone secretion, congenital adrenal hyperplasia, which causes sexual development disorders, and Asherman syndrome, known for intrauterine adhesions.

Thyroid Problems
Underactive or overactive thyroid function can lead to an inability to menstruate. This is because the thyroid regulates the body's metabolism and thereby affects hormone levels. During thyroid treatment, it is possible for menstrual problems to arise.

How Do Menstrual Inducers Work?

The progesterone naturally produced in the body after ovulation is synthetically provided to the body through menstrual induction medications. The medroxyprogesterone contained in menstrual inducers supplies the body with the progesterone hormone. When the intake of this hormone is stopped, it triggers bleeding, marking the start of menstruation. Progesterone prepares the endometrium for menstruation, and when its use is halted, the endometrium sheds, initiating menstrual bleeding. The event that triggers the menstrual period is the decrease in progesterone levels in the body. By promoting an increase in progesterone, the cessation mimics a decrease in progesterone in the body, thereby inducing menstruation.

How to Use Menstrual Inducers?

Menstrual inducers are medications available in tablet form to be taken orally. It is recommended to take them with water at the same time every day. They should be taken under medical supervision, and the doctor should be informed about any existing health conditions and other medications being used. If the individual has vaginal or breast cancer, this information must also be shared with the doctor. Various tests may be requested by the doctor before the use of menstrual inducers. The hormones that can be tested include:

• Progesterone and estrogen levels
• Follicle-stimulating hormone
• Testosterone and DHEA (male hormones)
• Human chorionic gonadotropin (beta HCG), a pregnancy hormone
• Thyroid hormones

There are also imaging methods that can be used, such as:

• Ultrasound
• Computed tomography
• Magnetic resonance imaging
• Hysteroscopy (used to visualize the inside of the uterus through the cervix)

In some cases, the use of menstrual inducers may not be advisable because their use can have harmful effects on the individual. These situations include:

• Recent history of stroke
• Vaginal bleeding of unknown cause
• Breast and uterine cancer
• Recent history of heart attack
• Bleeding disorders
• Liver problems
• Pregnancy
• Allergy to any substance in the menstrual inducer
• Plans for pregnancy
• Breastfeeding
• Recent surgical plans
• Diabetes
• Asthma
• Epilepsy
• Heart problems
• Elevated calcium levels in the blood

What Are the Side Effects of Menstrual Inducers?

Menstrual inducers can cause various side effects due to the presence of medroxyprogesterone acetate. If these side effects persist for an extended period, the pharmacist should inform the supervising doctor. If the side effects are severe, one should seek medical attention without delay. Emergency situations may include painful urination, lumps in the breast, or jaundice (yellowing of the skin). In very rare cases, serious side effects like blood clots in the legs or heart attacks may occur. These side effects often arise due to interactions with other medications. Some individuals may experience allergic reactions to these drugs. Potential side effects of menstrual inducers may include:

• Breast tenderness
• Acne formation
• Increased hair growth
• Drowsiness
• Gastrointestinal discomfort
• Weight changes
• Hair loss
• Sleep problems

Some side effects may lead to more serious complications. These may indicate an allergic reaction or a complication. Rare but serious side effects that may occur with the use of menstrual inducers include:

• Difficulty speaking
• Shortness of breath
• Chest pain
• Double vision
• Blurred vision
• Swelling of the eyes
• Depression
• Jaundice
• Fever
• Hives
• Itching

The use of menstrual inducers can be dangerous in some situations. If a menstrual inducer is deemed appropriate by a doctor, it is essential to provide information about existing health conditions and medications. Otherwise, it could lead to serious health issues. If various symptoms occur while using a menstrual inducer, one should seek medical attention as soon as possible and get support.