PCOS: Your Questions About Pregnancy and Menstrual Irregularities

Q: PCOS: Your Questions About Pregnancy and Menstrual Irregularities

You mentioned that you visited the website but didn't receive a response, which surprised me because we always respond if we see a question. <br><br>1. <br>Divina contains estrogen and progesterone, which are used for hormone replacement therapy in postmenopausal women or for tho

I really want to get pregnant

Hello Dr.
Jan,
I previously visited this website and tried to ask my personal questions, but I waited a long time without receiving a response.
I really need someone to help clarify my concerns...
I hope you can assist me!
I have been married for over six months, and my menstrual cycle has been very irregular (it was the same before marriage).
My husband and I had sexual relations before marriage, and we privately purchased "emergency contraceptive pills" (used more than 10 times).
After getting married, we decided to stop using contraception because we wanted to conceive.
I wonder if the irregularity in my menstrual cycle has worsened due to entering a new environment.

My cycle has been as follows: December 6 to December 11, 2001; February 6 to February 11, 2002; March 16 to March 23, 2002; May 12 to May 18, 2002; June 3 to June 10, 2002.
My period started on the third day of my marriage (December 8), and we have not used contraception since.
However, after two months without a period, I went for a check-up and was diagnosed with "polycystic ovary syndrome" (PCOS).
The doctor informed me that this condition can cause menstrual irregularities, and it is normal for periods to be delayed by 40 to 60 days.
He mentioned that my condition was not severe and advised me to wait for my period to come.
Subsequently, I had my period in February and March, but it was absent again in April, and I finally got my period on May 12.
I have heard that this condition can be treated, so I went to another hospital for a consultation.
The doctor drew blood to test for "prolactin and progesterone" and prescribed a medication called DIVINA, stating that it would help regulate my menstrual cycle and instructed me to take one pill per day starting on the third day of my period.

On June 3, during my follow-up appointment, the doctor asked if I had any abnormal bleeding, to which I replied no.
He informed me that my "prolactin and progesterone" levels were normal and that it was simply because my ovaries were still too young.
He continued to prescribe the same medication for me.
That evening, I noticed what seemed to be the onset of my period, which surprised me because I thought menstruation would only occur seven days after stopping the medication.
I had planned to finish my medication on June 2, but I missed doses on June 1 and June 2 due to being out and not bringing my pills, so I lost those doses.
However, on the night of June 2, I quickly took the last pill.
To avoid making my explanation too complicated, I have summarized my questions as follows:
1.
Are there any side effects from taking DIVINA? Is it normal for my period to come less than two days after stopping the medication?
2.
During the period of taking DIVINA, is it safe to not use contraception? What should I do if I accidentally become pregnant?
3.
Is the doctor's statement that my blood tests are normal and that my "ovaries are too young" accurate?
4.
What should patients with polycystic ovary syndrome pay attention to?
5.
Since I really want to conceive, what methods can improve the chances of pregnancy for patients like me?
6.
Can polycystic ovary syndrome be completely cured?
7.
I have heard that once patients with polycystic ovary syndrome become pregnant, they are at a higher risk of miscarriage.
Is this true?
Please help clarify these questions, Dr.
Jan.
I am really anxious...
>o<” Thank you~~~~~~

miko, 20~29 year old female. Ask Date: 2002/06/22

Dr. Zhan Deqin reply Obstetrics and Gynecology

You mentioned that you visited the website but didn't receive a response, which surprised me because we always respond if we see a question.

1.
Divina contains estrogen and progesterone, which are used for hormone replacement therapy in postmenopausal women or for those with irregular menstrual cycles.
It can help regulate menstruation, and withdrawal bleeding typically occurs two days after stopping the medication.
Short-term use generally has minimal side effects.

2.
Contraception is still necessary; if pregnancy occurs unintentionally, it could be harmful to the child.

3.
Without seeing the blood test results, it's difficult to draw conclusions.

4.
Polycystic ovary syndrome (PCOS) has several characteristics: (a) insulin resistance, (b) excess androgens, and (c) abnormal gonadotropin secretion.
Clinically, this may manifest as (1) initially normal menstruation that becomes increasingly irregular or absent, (2) hirsutism with coarse hair growth on the chest, areola, lower abdomen, and thighs, (3) upper body obesity, and (4) insulin resistance, which may present as acanthosis nigricans on the back of the neck.
Regular exercise and dietary control can help reduce weight and improve overall health.

5.
Ovulation induction medications or injections can be used to increase the chances of conception.

6.
Laparoscopic procedures to cauterize, perforate, or drain the ovaries can improve ovarian function and increase pregnancy rates.

7.
That is not accurate.

8.
After discussing for a while, are you diagnosed with polycystic ovary syndrome (PCOS)? The diagnostic criteria include the presence of a ring of small follicles surrounding the ovaries on ultrasound, and the ratio of luteinizing hormone (LH) to follicle-stimulating hormone (FSH) is typically greater than 3 in blood tests.

Reply Date: 2002/06/22

More Info

Understanding Polycystic Ovary Syndrome (PCOS) and its implications for pregnancy and menstrual irregularities is crucial for women experiencing these challenges. Based on your detailed account, it seems you are navigating a complex situation with your menstrual cycle and fertility. Let’s address your questions systematically.

1. Side Effects of DIVINA: DIVINA is a combination hormone therapy that contains estrogen and progestin. Common side effects can include nausea, headaches, breast tenderness, and mood changes. It’s not unusual for your period to arrive shortly after stopping the medication, especially if you missed doses. The timing of your menstrual cycle can be affected by many factors, including hormonal fluctuations and the underlying condition of PCOS.

2. Contraception While on DIVINA: While taking DIVINA, it is generally advised to use contraception if you are not planning to conceive. If you accidentally become pregnant while on this medication, it’s important to consult your healthcare provider immediately. They can provide guidance based on your specific situation and the potential risks associated with hormone therapy during pregnancy.

3. "Ovaries Too Young" Explanation: The statement that your ovaries are "too young" may refer to the idea that your hormonal balance is still maturing, which can affect ovulation and menstrual regularity. In PCOS, the ovaries may not release eggs regularly, leading to irregular periods. This is a common characteristic of the syndrome and can vary significantly among individuals.

4. Management of PCOS: Women with PCOS should focus on maintaining a healthy lifestyle, including a balanced diet and regular exercise, which can help manage symptoms and improve insulin sensitivity. Regular monitoring by a healthcare provider is essential to manage any hormonal imbalances and to track menstrual cycles.

5. Increasing Chances of Conception: To enhance your chances of becoming pregnant, consider the following strategies:
- Weight Management: If overweight, losing even a small percentage of body weight can help restore ovulation.

- Medications: Your doctor may prescribe medications like Clomiphene Citrate to stimulate ovulation.

- Monitoring Ovulation: Keeping track of your ovulation cycle through ovulation predictor kits can help you identify the best time to conceive.

- Fertility Treatments: If natural methods are not successful, consulting a fertility specialist may provide additional options.

6. Can PCOS Be Cured?: Currently, there is no cure for PCOS, but its symptoms can be managed effectively. Treatment often focuses on regulating menstrual cycles, managing symptoms, and addressing fertility issues.

7. Risk of Miscarriage: It is true that women with PCOS may have a higher risk of miscarriage compared to those without the condition. This is often related to hormonal imbalances and other factors such as insulin resistance. However, many women with PCOS have successful pregnancies with appropriate medical care and monitoring.

In conclusion, it’s essential to maintain open communication with your healthcare provider regarding your concerns and treatment options. Regular follow-ups and personalized care can significantly improve your chances of managing PCOS effectively and achieving a healthy pregnancy. Remember, you are not alone in this journey, and many resources are available to support you.

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