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Gynecology (Expert Forum)
menstration and
Answered by
Keith Downing, MD - Obstetrics, Gynecology
MA
This forum is for questions and support regarding gynecology issues such as: Cervical Disorders, Colposcopy, Cramps, Cystitis, Fallopian Tube Disorders, Menstruation, Ovarian Disorders, PAP Test, Pelvic Exam, PID, PMS, Surgery, Tests, Ultrasound, Uterine Disorders, Vaginal Disorders.
menstration and
by bm78, May 21, 2008 03:07PM
I have always had irregular periods, and was put on birth control to regulate them when I was 16. I am now 27. I went off birth control about 15 months ago. For 9 months I had no periods. I then got a shot and was put on utrogestan. I was told to start it 7 days after my last day of menstration and take it for 10 days or until I start menstration. I would always get to about day 7 and it would start. So I was having menstration every 18-20 days, and my menstration was typically only 2-3 days long each month and very light. I have had some tenderness in my breasts. I went back to the gynacologist and she said that I am not on a strong enough pill and my menstration is to often and has prescribed Aygestin and was told to take it 3 times a day for 10 days. I have read that the recommended dosage is 2 times a day. I am from the czech republic and the doctors here really don't care much to explain whats going on, and just throw pills at you if your having problems. I want a second opinion, does this seem like the correct treatment. I am afraid of the side effects of this drug. I also want to get pregnant in about 1 year, if possible. Has anyone else here gone through this, and what worked for them?
Doctor's Answer
by Keith Downing, MD, May 21, 2008 04:25PM
, May 21, 2008 04:25PM
Hello,
The importance of regulating your menstrual cycle is to prevent the inside lining of your uterus (the endometrium) from prolonged exposure to unopposed estrogen. Prolonged endometrial exposure to the uterine lining in the absence of progesterone can result in endometrial tissue overgrowth (hyperplasia) and the development of abnormal tissue (atypia). In your case I assume your physician believes your absence of menses (amenorrhea) is the result of not ovulating (anovulation). Anovulation can be the result of pregnancy, hormone changes to Thyroid hormone (TSH) or Prolactin, physical or emotional stressor, and commonly a condition called polycystic ovarian syndrome.
When a woman does not ovulate she does not make the necessary levels of progesterone to protect the endometrium.
Now, there are many ways to regulate the menses and/or to supplement a woman with progesterone. You have been prescribed progesterone only pills, which is fine. A Mirena IUD and Depo Provera are other alternatives, again, if available. You could also start a estrogen/progesterone containing birth control pill (or alternatives available in your country) if you have no medical contraindications. What has been recommended by your doctor sounds fine. There are side effects to all hormonal contraception. Talk this over more with your doctor. But you are okay to take what you have been prescribed.
Best regards,
Dr. Downing
The importance of regulating your menstrual cycle is to prevent the inside lining of your uterus (the endometrium) from prolonged exposure to unopposed estrogen. Prolonged endometrial exposure to the uterine lining in the absence of progesterone can result in endometrial tissue overgrowth (hyperplasia) and the development of abnormal tissue (atypia). In your case I assume your physician believes your absence of menses (amenorrhea) is the result of not ovulating (anovulation). Anovulation can be the result of pregnancy, hormone changes to Thyroid hormone (TSH) or Prolactin, physical or emotional stressor, and commonly a condition called polycystic ovarian syndrome.
When a woman does not ovulate she does not make the necessary levels of progesterone to protect the endometrium.
Now, there are many ways to regulate the menses and/or to supplement a woman with progesterone. You have been prescribed progesterone only pills, which is fine. A Mirena IUD and Depo Provera are other alternatives, again, if available. You could also start a estrogen/progesterone containing birth control pill (or alternatives available in your country) if you have no medical contraindications. What has been recommended by your doctor sounds fine. There are side effects to all hormonal contraception. Talk this over more with your doctor. But you are okay to take what you have been prescribed.
Best regards,
Dr. Downing
Member Comments (2)
by bm78, May 21, 2008 04:33PM
I believe I was told I have PCOS. If I want to get pregnant is this a good drug to take, or will I need to switch drugs to something else before I want to get pregnant. Should I ask for drug specifically? any recommendations for pregnancy with PCOS where you need a high dose of progesteron to regulate your periods.
