Why haven't I had my period one month after my miscarriage?

If a woman had regular menstruation in the past, but has not had menstruation for three months or more after an artificial abortion, and the endocrine function test of the gonadal axis is normal, it is usually considered to be secondary amenorrhea. So what causes amenorrhea?

1. Damage to the endometrium: Although the endometrium has a strong regenerative ability, the recovery of menstruation and fertility after curettage is still affected by the extent of endometrium scraped off. Some women choose small clinics for various reasons. During the operation, due to improper operations such as excessive suction of the uterine wall, excessive negative pressure during suction, and prolonged suction, or because the women themselves have had too many artificial abortions, mechanical damage to the endometrium occurs, which further damages the protective layer of the basement membrane, causing the endometrium to lose its normal repair and proliferation ability, and there is no normal endometrium to shed, so amenorrhea occurs. In addition, after the endometrium is lost, the front and back walls of the uterus can easily stick together. When the area of ​​endometrial damage is relatively small, it is often clinically manifested as less menstrual volume. In this case, it is usually possible to cure it through active treatment. However, if the endometrium is damaged over a large area and adhesions of the anterior and posterior walls are caused, it may cause permanent amenorrhea. At present, hysteroscopy can detect intrauterine adhesions and cervical adhesions in a timely manner, providing important assistance for timely diagnosis and treatment.

2. Cervical canal adhesion: When the protective layer of the basement membrane of the endometrium is destroyed, it may cause cervical canal adhesion and prevent menstrual blood from being discharged. At this time, the patient will experience periodic lower abdominal pain and anal swelling, and blood in the uterine cavity may be seen during gynecological examination.

3. Dysfunction of the hypothalamus-pituitary-ovarian axis system. Some women who have an unexpected pregnancy will become very nervous and anxious once they learn they are pregnant, and they will also feel fear and tension when facing abortion. This negative emotion disrupts the function between the central nervous system and the hypothalamus, and causes ovulation dysfunction through the hypothalamic-pituitary-ovarian axis, leading to amenorrhea.

4. Having sexual intercourse too early after an abortion. Usually women should try to avoid sexual intercourse within one month after having an abortion. If they have sexual intercourse too early, the uterus that has not yet been repaired may become infected, thus affecting its normal repair and even causing an inflammatory reaction, ultimately leading to amenorrhea.