What to expect from first gyno appointment

[goldflakepaint]

Hi everyone,

I have my first appointment after being referred to gyno on 3rd Jan.

As background- I was referred due to experiencing several cycles with 5-7 days of spotting before af. This happened after experiencing an 'abnormal period' in August where I had heavy bleeding and ovarian pain- at that point, an ultrasound was done which confirmed no cysts on ovaries or any other issues but they did find a small (1cm) intramural fibroid which they said was incidental and did not explain my symptoms. They also told me that it should not affect my fertility as I was already ttc at that point. However, since then, I have had all the spotting- also on cycle 10 and not a whiff of a BFP.

After reading up a bit, I'm wondering if I'm experiencing low progesterone/oestrogen dominance. I also have a short luteal phase (10-13 days if we're not including spotting but never longer than 9 if we are) and often get PMS symptoms although not massively severe. Thing is that GP did do day 21 bloods which came back normal (progesterone 55 when cut off is 30) but it was done at 4dpo rather than 7dpo so don't know if that affected the results?

I have been keeping record of my periods/spotting for months now and have recently starting charting- just done one cycle so far. Luteal phase temps have stayed high although also had a slow rise following ovulation so not really sure if that indicates anything? I have attached my chart in case anyone here is better at reading these things.

If anyone has had similar experiences and can give me a heads up of what to expect and what to ask (I tend to clam up around medical professionals unless I have given some thought about what to ask), I'd really appreciate it. Sorry for the essay!

Watching with interest! I've got my first gyno appointment on the 2nd! I went to the gp's this week because I've had two periods this month. I've always been regular. I went for blood tests too, hopefully they'll have the results when I go to my appointment.

Getting pregnant is just pot luck. Many couples without any issues will take a year or more to get pregnant. 80% in a year and 90% in two years.

The gyno may do more tests (like an hsg to check tubes). They might review your results and say ring back in 6 months moths. What happens at this point varies widely!!

Has your oh been tested?

It's good you're getting the tests done, but they often find nothing wrong, which can be very frustrating. Good luck, it's a minefield.

alittlepieceofme How did your appointment go today? Did you get your blood test results? I think it's important to get anything checked out that is unusual or out of the ordinary and it's good that your GP was so responsive- mine is quite good but I had to wait a few cycles before my spotting was no longer viewed as a one off and no big deal.

@physicskate The appointment is focused on the unusual amount of spotting and the fibroid as opposed to investigating fertility problems per se, like you said, we are just within the year so could still be part of the 80%. Not going to lie, I am feeling less and less hopeful for that as time goes on but mainly because I'm not sure that my uterine lining (as it currently appears) will support a pregnancy. Dp is a statistician and loves to remind me that these numbers can be uninformative anyway and he remains optimistic. Not had any tests done on him as he is not super keen until we hit the recommended year and I'm pretty sure he would be turned away by his GP anyway because of this. And thanks for the info, I hope that at least the issue is taken seriously and that it is looked into- I know that is likely to take some time but I think I will feel little better to get the ball rolling. I have done some research and plan to ask about possible luteal phase defect and endometriosis as well as further investigations regarding this fibroid but we'll see what they say! Hope everything is going well with your pregnancy.

Hmm. Just having a read of NICE guidelines again and just noticed that they do not recommend further investigations of possible luteal phase defect so probably will be barking up the wrong tree if I try to discuss it tomorrow. We'll see what happens, may have to get supplements reviewed by a herbalist or give acupuncture a try to see if it makes any difference.

Have you had full blood tests? When I had similar symptoms, they found I had vitamin b12 deficiency and low folate. The spotting reduced to one day before period after treating these.
I also had a cyst. I took a list of symptoms to my appointment, just in case I forgot anything. Hope all goes well.

@Til89 Just day 1-4 and day 21 blood tests to confirm that I was ovulating. Came back normal but as I ovulated later than usual that cycle the timing was a bit off. Thanks for sharing your experience, it sounds like it might be worth asking for full blood tests assuming they don't offer this. Writing down a list of symptoms is a good idea too.

Thanks everyone for their thoughts. Appointment was okay, not super helpful but I didn't expect it to be right away. I'm going to be booked in for a hysteroscopy to get a better look at the fibroid in case it has changed and check for any polyps, adhesion's etc. If they find something significant, they should be able to sort it out and my womb will get a sort of spring clean which is nice and could increase my chances of getting pregnant.

But if they don't find anything, it'll be chalked up to a hormonal imbalance and consultant said that there would be not be much that could be done about that as both of our lifestyles are healthy. I'm not convinced and have booked an appointment with a herbalist to get their thoughts on my luteal phase.

In any case, in the next few months, I'll either be pregnant (kind of the preferred option) or I'll have some answers (even if no treatment) and will be really close to ttc for a year so will then go for further tests anyway. So I feel quite positive about things moving along regardless. We'll see what happens- going to focus on getting on with life now that I feel that we are doing everything we can do right now.

@goldflakepaint my appointment was fine thanks, bloods were fine, she didn't find anything in the examination Either! She is going to send me for an ultrasound to see if that shows up anything! Other than that it's just wait and see what happens with my periods!