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Hi Tobysgirl1

Welcome to the board. She's right, they will probably need to force a period before you start the Clomid. Be careful in going so long without a period, I have always been irregular, sometimes ony 3 times a year. My gyn told me that cancerous cells can build up if you don't shed your lining at least once every 3 months. She used to give me Provera to force a cycle.

I also used Clomid, you take it a couple of days after your cycle starts. No biggie with side effects, just pills each day.

Good luck, ask your dr about the cancerous thing.
I'm a little late here. too! Welcome to the board. I went over 2 years without AF. Went to my OBGYN in February '06 and he put me on Provera to start AF and then clomid. I was on all that for a few months (without looking at my chart I don't know exact times) then he sent me to the Fertility clinic in June (I think) I was diag. with PCOS and am now on Provera (if I don't start normally), Clomid, Dexamethazone, Metformin, estrodal, and something else. I had my first big egg this month and surged and took my shot Saturday. I go in Friday for b/w to check my progesterone level and then it is a waiting game until I test January 12. All of this was to say Clomid does work, but not on everyone and not all the time. There were a few months that I didn't O at all. Don't loose faith. Hang in there.

Sending baby dust your way! !

Leslie
Hi Everyone!

Well, I had my first Dr. appt today to begin investigating why I haven't had a period for a year and hopefully what can be done about it! You guys were so right! Such smarties :) He has me taking Provera for 10 days and then getting bloodwork on day 3 of the period that it will induce. They will measure estrogen, FSH, LH, Testosterone, and Prolactin, among others. According to him it is likely that I either have hypothalamic amenorrhea (mainly caused by low weight and/or stress) or a result of having polycystic ovaries. He took an ultrasound to confirm that my ovaries were still polycystic, and indeed they looked like two pizza pies loaded with pepperoni. So in about 2 weeks we'll have all the labwork done and hopefully the hormone levels will tell him which one of these (or both?) is my problem.

Anyone know how you treat hypothalamic amenorrhea or polycystic ovaries? I've already gained a little less than 5 lbs while on vacation and am aiming to gain about another 5 or 6, so hopefully that should help. Also, I'm trying some relaxation techniques at work, but it's not easy!

Hugs and thanks!
I'm glad you finally got to the Drs.

I think you have hypothalamic amenorrhea. I was also misdiagnosed with PCOS based on only ultrasound findings. However, after going on estrogen shots for 6 weeks my cysts totally disappeared. PCOS cysts don't disappear that quickly.

Don't be suprised if the provera does not induce bleeding. This is very common with HA because our estrogen levels are low. Unfortunately (or fortunately) the condition can only be reversed by replacing the missing metabolic signals to your brain (gaining a lot of weight and eating properly, etc).

You said your BMI is 18, right? Your BMI should be more like 21-22 for AF to come back. Did you get regular cycles before the pill? Did you weigh more then?

Clomid works in some cases of HA but not all. Your RE may want you to start right away with injections. I'm still holding off and seeing if my cycle returns on its own (clomid does nothing for me). I still struggle with weight gain because I'm recoving from bulimia/anorexia. It is psychologically very traumatizing to me to gain weight but I've put on about 12-15 pounds in hope of restoring AF.

Best of luck to you. Like I said, HA is reversible it just takes time and effort.
I'm on day 2 w/o Provera and still nooo period. Waiting...
there were some months that AF wouldn't show up until a week or more after the provera. All this stuff does work. I am 7 wks now and hoping for a noneventful pregnancy.
WOW finally... you girls sound so much like me! I was diagnosed last week with PCOS but I really dont have many of the symptoms. He did a sonogram and said I have not been ovulating... then some blood work that confirmed my levels are out of wack.

But I am not overweight, I do not have acne and really dont have excess hair growth either. Do you think maybe Ive been misdiagnosed???

The doctor didnt seem concerned with my weight at all. I have teeny bones (size 5 shoe and the smallest wrists) and am 5'1 and weigh 97lbs. Believe it or not thats up from 94.5 a few months ago. I went off the pill in June and my weight literally fell off me from 102 to 94.5. I guess because of my bone structure the gyn wasnt concerned about that though. Maybe he should be????

Like you guys my FI is in the medical profession too. Hes PGY3 in ortho surgery. Still a long ways to go so I feel your pain about the no money thing. I did 5 days Provera at 10mg and just got my period but only for 1 day... which seemed really weird for me. My gyn has me starting Chlomid saturday (day 5) and taking 50mg for 5 days to see if I ovulate. If nothing happens my FI is coming with me back to the gyn on day 30 (march 1) to decide what our course of action will be for the future. We may decide to go straight to the RE.

Im glad to see people are in a similar boat to me :-) ANd i am wishing us all goodluck.
Tobysgirl-

That is classic hypothalamic amenorrhea bloodwork. I can almost guarantee it is related to your weight/exercise/eating habits. If you put on weight the estrogen will come up. Your progesterone is low because you aren't ovulating- no ovulation=no progesterone. How much of an AF did you get after the provera? Was it full on bleeding or just spotting?

Luckily this type of infertility is 100% reversible if you make the appropriate changes. If you aren't ready to gain the weight, etc, your RE can probably try you on clomid (if you got AF from provera) and if that doesn't work- move to injectibles.

I would like you to check out this forum on HA:

[url]http://www3.fertilethoughts.com/forums/showthread.php?t=343535&page=1&pp=40[/url]

All of the girls on it are in the same boat as you. Good luck.
ngolden, I think you've hit it on the nose with the hypothalamic amenorrhea. The puzzling thing is that, although I'm slim, I'm not "skinny" and I definitely have curves. In trying to get pregnant I've put on about 8lbs or so, and now wear a size 29 jeans (not skinny!). I just thought HA was a problem for women with eating disorders, not someone like me who is within the healthy weight range.

I did respond to the provera challenge with about 5 days of bleeding (moderate the first three days and v. light the next two). The doc will probably put me on Clomid, which frankly scares me. I would like to have a normal period again and thus allow for the possibility of pregnancy, but to deliberately take a medicine that could very well make me pregnant is a tad frightening. Although I look forward to having a little baby and being a mom, part of me is scared to be so proactive about getting pregnant.

By the way, I took a reproductive endicrinology course in college and remember MANY studies indicating that even a minor weight gain (like 5lbs) tremendously improves a woman's odds of getting pregnant. You're absolutely right that there's a correlation. It's just weird how some very skinny women get pregnant easily and have these "basketball" bellies, while other women who are normal weight can have so much trouble.

My hubby is chief resident of surgery, and then he starts his fellowship in June (so he'll get a real paycheck in 2008!). I adore him, but residency is a PAIN! Especially when he's getting phone calls all hours of the night, or when he's on-call an entire weekend and comes home Sunday night and just sleeps. All of his friends are doctors too, so even when we go out and socialize it's all about work! He is doing important work though and I'm proud of him. His thoughts on all of this? He was about as surprised and bewildered as I am. Good thing we have specialists.

Thanks for the link to HA, ngolden. Very helpful!
I am SUCH a dork.

I jumped the gun--my estrogen and progesterone levels are NORMAL for day three of your period, my RE told me after I wrote all of the above. I had the report faxed to me before my RE appt so when I read "<32" indicating in the range of post-menopausal, I didn't realize that they dropped that low right after you get your period. LOL! Any, I still have HA he said, the disease of athletes, models and stress-cases (starting to think I may be part of the latter group, and it's not helping that I'm not pregnant. Plus I think my boss thinks all these "Dr. appointments" are really interviews for another job, but he is paranoid. Makes me hate him and my job more.).

Next steps: see if I ovulate in the next two weeks on my own (I doubt it--a quick look at my ovaries Thursday morning showed they were quiet. Boo). Do the provera to get a period and set my egg timer back. Then take Clomid. Aymie, what are the problems w/ Clomid?

My hubby will do endocrine surgery next year, which I am happy about because he tells me there aren't any unplanned surgeries. So far it sounds like he'll be able to take more vacation than I will next year, unless of course I get preggers and quit my job. I think I have the opposite problem as you do, Aymie. Dear hubby's in the camp of "under diagnose" when it comes to treating me. The other night I got terribly sick--nausea, stomach pains, and a strange itchy rash. After what seemed an eternity begging him to do something, he finally roused himself and told me to lie on the floor. I obeyed, thrilled that I would finally get some help from him. He starts pushing and prodding my belly and then finally he says, "You're fine. Go back to bed." Excuse me, but I don't think I am fine. Just because he didn't find my appendix to be the size of an obese gerbil, doesn't mean I'm not sick! You see, as a surgeon, unless he can find something to cut or cauterize, I'm not sick LOL! So funny. I know some doctors are the exact opposite with their families, obsessively worrying about every little thing. I don't know which is better to have, but I'm certainly happy that I have my own RE!

Have a great Sat, Ladies!





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