No AF since stopped BCP - any advice...?

[daisyhun]

Hi - I've just found this website and I am hoping someone can help me - I'm feeling very alone atm!

I came off BCP in April to ttc baby #1 and after my last withdrawal bleed on 18 April I have not had AF at all so presumably have not ovulated either. I have seen my doctor 3 times and she has finally referred me to a consultant, appointment to follow. I've been taking Agnus Castus for 2 months now and stll nothing and wondered if anyone has been in the same position? Any advice? Is my consultant likely to put me on clomid straight away to kick start my ovulation?

Accupuncture may help.

I'd tell the consultant you are taking agnus castus. It's very important that he/she know exactly what you are taking, including herbal meds.

Clomid should NOT be taken lightly. It would be nice if it could be determined why you are not ovulating first. Sometimes, a condition like thyroid problem or pituatary gland problem can cause ovulation to cease. These can be treated with appropriate drugs. Similarly, some conditions like PCOS can be treated with drugs used to treat diabetes and these alone can sometimes alleviate the problem.

Thanks - I'll tell them I've been taking AC. I've been on BCP since I was 17 i.e. for 10 years with no breaks so I'm wondering if it is a background problem which if I hadn't been on BCP would have arisen earlier.

Any ideas what kind of things the consultant might ask/do to test for problems? How long is it likely to take?

No idea how initial consults are handled here in the UK. In the States, an initial uptake would involve a lengthy questionairre about your own and your family's medical history, STD screeing, smear test, bloodwork, etc.

It's possible sometimes for the Pill to mask the symptoms of an underlying disorder. It's good to find out, however, if there is not another problem, unrelated to the reproductive system, that could be affecting ovulation - such as some other hormonal disorder (diabetes, thyroid, pituitary, etc.).

Have you tried the book 'Taking Charge of Your Fertility'? It's supposedly quite informative.

Good luck! Keep us posted! There are also many TTC threads here worth checking out.

Hi Daisyhun,

It is actually not wise to self medicate with Agnus Castus as it can sometimes make things worse particularly if there is any underlying hormonal problem like PCO or PCOS (which could be a possible scenario in your case given the lack of periods). Please seriously consider stopping taking this as of now. If you really want to continue taking it then would strongly suggest you seek the advice of a medical herbalist beforehand. The cons may well tell you to stop taking it; in any event you must mention that you have taken this previously.

No AFs mean no ovulation has taken place.

Am glad to see you have been referred to a consultant for further evaluation. You need a diagnosis of the problem first and foremost. Clomid as someone else rightly pointed out should not be taken lightly - it is actually not suitable for every single women with ovulatory problems to take. Also if you are given clomid you should have monitoring (blood tests and or ultrasounds) otherwise there's no way that they can tell if its working to its best effect.

Would say that there is no real evidence to suggest that the pill is responsible for failure to ovulate; it is likely to have masked the symptoms of an underlying problem.

Accupuncture is certainly not going to do any harm but you need to bear it mind this may not have any effect on any underlying problem present.

Usually the first appointment will consist of a chat with the nurse or someone who works closely with the consultant in question. They will ask you both about your menstrual history and general health. They may also ask if you have had any sort of abdominal surgery to date. If at all possible both of you should attend this appointment as such appointments can and do cause considerable nerves.

Thanks - gosh I hadn't realised that agnus castus might be doing more harm than good. I have reached the end of the pack I was taking so I won't buy any more for the time being and I certainly will tell the cons that I had been taking it - thanks for that.

There is an accupuncture clinic close to where I live which specialises in fertility and gyne problems so maybe I will give them a ring - as you say it can't do any harm.

I had a pelvic scan last year as I was having really bad period pains (even though I was on BCP) and they suspected endometriosis. The scan showed I probably didn't have that or PCOS so an underlying hormonal problem might be the cause.

Thanks for all your advice - I was feeling v alone and confused (still v nervous so will try to drag DH along to the cons appt for moral support!).

Hi Daisyhun,

Would say that endometriosis (if this is there and as a former endo patient I hope you do not have this) is not picked up on an ultrasound scan - the way that endo is usually determined is through a keyhole surgery type operation called a laparoscopy.

If your periods continue to be very painful they may well want to do such surgery. This is certainly something that will need mentioning to the cons at your initial appointment.

The cystic follicles associated with polycystic ovaries are very small and it can take a highly skilled operator to spot them (also such cystic follicles disappear only to be replaced by further cystic follicles).

Do take DH along to your appointment with the cons when it comes through if at all possible. Such appointments can and do cause considerable nerves and moral support is vital. You will both need to be seen and tested further in any event and the three of you will need to be able to work together as a team.

Hi - Just thought I would update you all - I went to my consultant today (private) and he diagnosed PCOS straight away with the aid of an ultrasound scan and blood test. I'm gutted but at least they have found out what is wrong. Once the blood work results come back and DH sperm count has been tested he will put me on either metformin or clomid. Fingers crossed I can get a BFP soon!!

Daisyhun,

Sorry to read about the PCOS diagnosis. Its a PITA to have as a condition. I also remember that felling gutted feeling too.

A caveat re clomid - ensure the consultant actually thinks you are a suitable candidate to take this drug (its not always suitable for all PCOS patients). He may actually want you to take both metformin and clomid together (this seems to work better than just clomid on its own for some PCOS patients).

Ask lots of questions re the clomid if it is prescribed. You should only be on it for six months max after which time other treatments should be looked at (injectible drugs, surgery).

You need to be monitored whilst on clomid as well preferably with blood tests (it can affect LH levels; if your LH levels are very high to start with then it may not help at all) and ultrasounds (to check that an egg has actually left the ovary).

I wish you well because you may be in for a rough ride. By the way did he comment at all on the pelvic scan that you had previously?.

Hi. I'm feeling ok about it now - I guess it's just one of those things. I have the most fantastic consultant who is a specliaist in PCOS and is so helpful. He said the condition is mild so may not have been detected when they scanned for endometriosis last year and it is likely only to have developed very recently whch is also why it may not have shown up last year.

I'm going back to see him with DH on Monday when he will have the results of my blood test and DH's sperm count. He's going to do an x-ray type test to check my fallopian tubes are open and then I think he will prescribe either clomid on its own or clomid with metformin depending on the insulin levels in my blood.

Thanks for all the info and fingers crossed it works soon! Lots of baby dust to all with PCOS!