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Amenorrhea

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I've been suffering wih amennorhea for 8 months now and the doctors are at a loss. I was on birth control for 12 years but started having irregular periods. I've since stopped the pill and have yet to have a period. I constantly have stomach and abdominal discomfort, sometimes severe. I have been put on numerous hormones, had blood tests and sonograms and still no conclusion. Any ideas? I am in pain and frustrated.

Category: OBGYN

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Category: Infertility Specialist
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Hello,

Thanks for writing to us with your health concern.

After stopping the birth control pill, this sometimes happens.
It is called post pill amennorhoea.

It is generally treated easily - with progesterone withdrawal bleeding, or bromcriptine / clomiphene .
Please let me know what tests have been done so far, if you could upload them, I will have a clear idea.
Also, what hormonal regimes have you been put on so far ?

You should be having the following workup ideally -
1. Complete internal check up - per speculum and per vaginum evaluation.
2. Hormonal measurements - FSH, LH, TSH, Prolactin, Serum estradiol, OGTT, DHEAS, Free testosterone, AMH
3. Pituitary imaging.
4. Testing for endometrial tuberculosis ( endometrial biopsy )
5. Sonogram ( pelvic - done transvaginally ) .

You can reply as followup
All the best.
Please feel free to discuss further.


Patient replied :

I've had tests done to check for abnormalities with my thyroid, prolactin, testosterone and pituitary glands. I've also had the transvaginal sonogram and so far nothing has looked irregular according to the obgyn. I have also been given two 15 day rounds of progesterone and had a complete internal check up.

Thank you.


Please discuss with your doctor regarding cyclical estrogen and progesterone.
This is different from OC pills.
First estrogen is given for 21 days, and then progesterone is supplemented from day 15 - 25 ( since there is no period, this can be started arbitrarily, considering any day as day 1 ).
Most patients respond to this.


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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