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Last Updated:
Sep 10th, 2007 - 18:59:21
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Question
I had my one and only natural menstrual period when I was 13. After 3 years passed with no other periods, I was tested and I only recall something about no FSH. I was told to take BCP for 3 months straight when this was found out. This caused periods to occur, but after I quit the BCP, no periods. And we left it that way for several years, until after I got married. My GYN at that time said I should be having periods at least once every 3 months, so he put me on BCPs. I took them for 3 years straight. Then in 1999 I wanted to get married in the Church, and I didn't want to be taking BCP anymore, so I quit that. I never got pregnant, and all periods stopped since then.
7 years have passed and I have a new GYN, he too said I need to have periods every 3 months, else my risk of cancer goes up. I assume uterine or ovarian cancer he meant. My grandmother died from one of these cancers (Dad cannot recall; he was only 9 when she died).
So my questions are: how is taking the BCP causing me to have periods, and what is the chance I am not ovulating? I really don't want to be on BCP if it is against the Church's teaching, but I also don't want to take a chance of getting cancer or something else unsafe to my health.
I have no intentions of have any surgery to correct any bodily anomalies (like blocked tubes or adhesions). I am 40 years old now, and believe a first pregnancy now with other health issues (high blood pressure) is another risk I would not like to have. My concern is not to be doing a grave sin, yet to take care of my own health. What is the best answer for me?
Sue
Answer
Dear Sue,
If you were younger it would be important to pursue the cause of your absence of periods, and attempt to restore normal cycles. At this point, the focus on your overall health is more appropriate. If you are not having periods, you are not ovulating. Rather than using birth control pills, taking supplemental estrogen and progesterone would be a better therapy if there were a deficiency.
First of all, it would be important to check if you are in menopause or premenopausal. Stop birth control pills and wait at least two weeks. Then get hormonal studies including FSH and estradiol. If your FSH is high, you are menopausal or premenopausal. If you are menopausal at age 40, low dose estrogen might be appropriate for the next 5-10 years.
If you have detectable levels of estradiol (estrogen) or take low dose estrogen supplements, I would suggest a natural progesterone such as Prometrium for 10-14 days every one to three months. This will help protect you from breast and uterine cancer. Even if your estradiol levels are low (under 50), if you are not ovulating you will suffer from an imbalance of excess estrogen unless you take progesterone. You may get a period after taking the progesterone. If you do not, I would still take progesterone every three months until you are in menopause. If you get heavy bleeding every three months, it means you are building up an excessive uterine lining and should take the progesterone for 10-12 days monthly.
It is also possible your lack of periods might be related to PCOS (polycystic ovarian syndrome). Get blood tests for diabetes. If you are diabetic or prediabetic (this might be connected to PCOS), consider treatment with metformin. This diabetes drug can restore normal ovulation in some women. Ask your doctor to test your levels of testosterone and DHEAS. Elevated levels could confirm PCOS is your main problem. Finally, get appropriate tests to make sure your thyroid is functioning normally.
In summary, it would be important to get some idea from hormonal studies as to the cause of your lack of periods. The test results would help direct your treatment, as well as helping prevent breast and uterine cancer.
Mary Davenport, MD
Dr. Mary Davenport is an obstetrician-gynecologist in private practice in El Sobrante, California.
She graduated from Tufts University School of Medicine and completed her residency at the University of California, San Diego.
Dr. Davenport is also a Fellow of the American College of Obstetrics and Gynecology.
She has an NFP-only medical practice and is a Medical Consultant in Natural Family Planning.
She is a board member for CANFP and the American Association of Pro-Life OBGyn's.
© Copyright 2005 by CANFP
The information on this page and web site is for informational purposes only,
and is not a substitute for medical diagnosis and treatment by a physician.
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