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Irregular periods and fear of infertility

Resolved Question:

Dear Doctor,

About Me:
I am a 23 years old female engineer.
My Problem:
I have irregular periods from start (I was 11 years old). Now I am 23 years old and married (4 months). We use barrier methods for family planning. But I am worried whether I would be able to conceive in future because of my irregular period.
My observations:
My period is maximum 5 times a year. Mostly with heavy bleeding. I cant say it is once in 2 months or 3 months. It comes any time with a gap of minimum 2 months between periods. And in the past 3 years I have observed that sometimes the period lasts for 2 weeks or even a month. I have blood clots seen in my period blood. Now I am in period for a month with very light bleeding and clots for which I am worried.
Treatments I had:
My Mom had a fear that medicines may cause side effects so 2 times I had Ayurvedic Treatment which was not useful but instead caused period more than a week and still irregular. I dint have a medical check up for this.
My physique:
I am 158 cm tall with 63 kg weight. I have hair growth on my face (My maternal side females have the same so I hope it is kind of hereditary)
What I need from you:
Kindly tell me what is your conclusion and suggest me what I should do next. I never cared of this before my marriage but now I regret for the same.

Regards,
Maria


Category: Infertility Specialist

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Category: Infertility Specialist
 20 Doctors Online

Hello,
Thanks for writing to DoctorSpring.com with your health concern.

I have gone through the blood test reports that you have attached in this query.
I am very sure of the diagnosis, only some reports remain to be done in this case.

The condition is called PCOD - PolyCystic Ovarian Disease.
In this condition, there is underlying hormonal imbalance - the exact cause is not known.

The ovaries every month produce one mature follicle, which ruptures during ovulation, and then menstruation occurs.
IN PCOD, the ovaries get studded with many small follicles, and none of them mature regularly every month to form an egg.
Thus cycles are irregular, the uterine lining gets built up, and when periods occur after delayed length, they are heavy and with clots.

Also, due to hormonal imbalance, there is excessive hair growth on the body - on the face, stomach, chin, legs etc.
The hair is dark, thick and coarse, like male pattern hair growth.
Also, there could be acne.

Apart from the reports you have done, please get the following investigations done -
1. Repeat FSH and LH ( if not done earlier on day 2 of periods ).
2. AMH
3. Pelvic ultrasound scan done transvaginally.
4. DHEAS, free testosterone
5. Fasting serum insulin, OGTT, Lipid Profile

Exercise regularly and eat healthy.
There is no cure as such for PCOD, but medications like Metformin often help to improve symptoms, such as irregular cycles and excessive hair growth.

Women with PCOD often face difficulties in conception due to erratic ovulation, but yes, most go on to conceive after treatment.
Cycles can be regulated with cyclical progesterone therapy ( if you wish to conceive ) or oral contraceptive pills.
Do not delay pregnancy for long.
Take regular folic acid supplements.

When you start planning for a baby, first try naturally for the first 6 months ( checking for your ovulation by ultrasound as your cycles are irregular ).
IF you fail to conceive, seek medical guidance.
Medications like clomiphene citrate would mostly be required in your case to induce ovulation, and then pregnancy can definitely be achieved.

Minimize stress and worry, as it will negatively impact the hormones.
Stop taking Ayurvedic medications - it will worsen your problem.

All the best.
Please feel free to discuss further.


Patient replied :

Dear Ma'm,

Thank you so much for the reply.

Regards,
Maria


Best wishes. Your consult will be open for 1 month, please feel free to discuss further.


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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