No period, Provera test, recovered anorexic

[agoddard88]

Hi,

My husband and I have been ttc for 1 year. Prior to this, I had been on a double dose of BCP for 13 years with no break, and I also suffered with anorexia for 4 years (now been at a healthy weight for 3 yrs or so).

Despite coming off BCP 1 yr ago iv had no period or bleeding, and have just had my first gynae appt. He has prescribed Provera, and says most likely cause of no ovulation is due to pill withdrawal or hypothalamic ammenhorrea from old anorexia. As it stands, I'm confused as to what this means for treatment options. Has anyone been in a similar situation? Is there anyway to induce ovulation in either cadr? Atm we are waiting for FSH test results and to see if I bleed on Provera...but I'm worried and scared that my past has messed everything up. How can hypothalamic ammenhorea be treated? What about if its pillbwithdrawal?

Any advice/support/personal experience sharing would really help as I currently feel very confused and scared.

Why were you on a double dose of BC? I would imagine that alone would cause a lot of damage from the intense hormone levels. When I came back off BC last year it took well over a month for things to get kick started again. I remember during this reading of some women who's periods took a year or more to return. For some unfortunately it did not return. But...... there are still ways to jump start ovulation despite this, if this is the case. It just depends how far you are willing to go, such as hormone injections and so on.

In all honesty, I would not start panicking before you have all the cards on the table and see what the end results are. It will only drive you bonkers.

My story is just like yours although the anorexia part lasted over 18 years! I so not have periods or ovulate on my own. I was given clomid initially with no response (apparently typical in our situation??) then on first round of injections conceived my son who is now 2. Now in the system again for DC2.

Hi; I recovered from an eating disorder to find that I was amenorrhagic even after reaching a healthy weight; I didn't respond to Provera, and conceived our DS1 through IVF after several rounds of ovulation induction injections, like the PP (we went to IVF only because of my age, not due to failure to ovulate with 'help'). After DS1, my periods restarted naturally for the first time in 10 years, and DS2 was a natural pg.
The thing about HA is it's just not quite as straightforward for some, unfortunately, as regain weight and restart periods. The pituitary gland seems to sit in a very delicate balance - I always thought of it as my body had to learn to trust me again. Some people think some women need to be at a higher BMI than others to ovulate, others think stress and exercise can also contribute, even at a normal BMI.
Firstly, take heart. My old fertility clinic told me that of all the causes of difficulty to conceive, this is one of the easiest to treat (with super-ovulation if your periods don't restart) and with one of the most successful outcomes.
Secondly, HA after ED recovery has a much higher profile in the US and you can find support and advice from, firstly, a blog called 'No Period, Baby' by 'Nico' (she doesn't post there much now but it's still useful) and even more importantly from a site called Fertile Thoughts which has a whole area devoted to HA recovery and getting pregnant naturally - www.fertilethoughts.com/forums/hypothalamic-amenorrhea/
Good luck, be kind to yourself - you've done brilliantly to get to this point.

Thank you for your reassurance, it has really given me hope to know that even if it is HA there are ways to help. I know its early days, but can I ask, did you have to pay for the IVF injections (UK)?

Funding is dependant on where you live (ie according to your local CCG policy).

The fertility clinic will be able to advise you

As above, it does depend where you are. I had the injections in 2009-10, at that point they weren't covered, by our local CCG, though IVF was. Don't give up hope of your periods returning naturally just yet - I've seen lots of cases where they have, even after a failed provera challenge. It does, I'm afraid, sometimes take a little time though.

Ignore "camille" there

OP, I wanted to give you some hope that you may not need to progress to injections or IVF. I suffered from HA and after a bit of a false start, managed to conceive my two with Clomid.

I say "suffered" past tense because once I had my first, my hormones seemed to "reset" and now I have the opposite (probably perimenopausal) problems with heavy and close-together periods.

I have reported all of camille's posts that I can find...do the same if you can

Reported - wtaf?

Stupid trolls all over the site with this "spellcaster" shite

They have hit a new low coming on this topic though.

I agree anyfucker, that's what enraged me so much. It's a specially cruel person who could do that

Indeed.

I cannot understand how some people take advantage of other peoples misery.

Anyway, ignoring that, Thank you for sharing your stories, it's put a smile back on my face and given me hope! I have finished my 5 days of provera now so its time to wait. I have another Gynae appt in 2.5 weeks but I don't know where we'll go from there (I assume it depends on whather I get AF between now and then).

Along with the provera test, he has also just tested my FSH levels..does anyone have any idea how that affects the diagnosis given by the provera test?

FSH tests your ovarian reserve ie. whether they are capable of being stimulated into releasing an egg. If it is high, it means that your hypothalamus is trying to give them the messages but they are not responding.

Mine was initially high on a one-off test and I got a diagnosis of premature menopause

Referral to an endocrinologist overturned that though, thankfully (and I was subsequently successful with Clomid)

I think the provera test has failed...I've had nothing. What does this mean? I don't know if that's typical of hypothalamic ammenhorrea, or post-pill ammenhorrea, or something else entirely. My next appt isn't for 2 weeks and I can't stand not knowing what it could mean for that long...any advice would really help

Hi

This is weird I am having a very similar issue. I came off BC pill in February and had no period since. Dc did full bloods and all came back 'normal' - whatever that means! So it was suggested I may have HA - was 48kilos and 5ft exericising most days a week and lots of running/hiit. So about 8 weeks ago I stopped all exercise and upped food to over 2000 cals a day. Have gone up to 54kilos and feel horrible! But BMI is now over 23 which is what Dc wanted it to be. So then tried Provera - took for 10 days and came off on Friday last week. Have been off it for 4 days and Dc said I should have withdrawel bleed after 3 days :( Think I will book another appointment with Dc but not really sure what is next - she suggested an internal scan. Have read that provera can take up to 2 weeks for withdrawel bleed - any ideas?

I've now been off the provera for 8 days and still nothing. My bloods show that FSH, prolactin and Oestrogen are all normal (which I wasn't expecting). From what I've read about HA, Fsh is usually low, so I'm a little confused! I just hope that at my next appt he has an idea to try to stimulate ovulation...I don't know if clomid/HMG would work in my situation but I'm hoping it's not just a case of go straight to IVF

Well, very strange, woke up this morning to what I can only assume is my withdrawel bleed. Very light - really just the odd bit of spotting. Not sure if it makes a difference how much bleed there is? But as far as I know this means I don't currently have HA which is the best news ever but does this mean that I don't ovulate? I'm really confused?

Congrats Dulciemouse, that's good news. I still have nothing, and I really don't understand why my blood tests are all normal if its HA. maybe i'm wrong, maybe Normal estrogen and FSH is standard with hypothalamic ammenhorrea...can anyone shed any light?

Hi another success story here, I dropped weight quickly when I was 15 and then went on the pill for 14 years with no periods when I came off it. Was diagnosed with HA as I had low oestrogen and cysts on my ovaries. Clomid didn't work for me but injectibles (menopur did) I had to pay for the injectibles myself (was about 700 pounds) but the rest of the treatment was on the NHS. Feel free to PM me if you have nay questions, I did respond to provera though and had withdrawal bleeds from the pill xxx

Thanks agoddard88. I went back to the doctors yesterday and she did ovulation tests etc. (should have been ovulating at the time) and i'm not ov. Next step for me is that she wants to wait and see if I get my period (but thinks i prob won't) so then has given a perscription for another round of provera - i then have to have blood tests between days 1-5 of period and day 21 of cycle. I spoke to her re exercise etc. I am now BMI 23 which is where she wanted me to be and she said it is fine to exercise but not every day just a couple of times a week and to keep an eye on weight to make sure it stays stable.
I don't know re the blood tests being normal - I find the whole thing very confusing. This is a good page on it www.myfoodnfitnessdiaries.com/ha/ this lady writes a blog and has suffered from HA.
I would recommend that you return to the GP as you had no bleed and discuss next steps?