Women's Health Community

Dear nikieia: If you had irregular cycles for the last several years while taking birth control pills (BCPs) that would only indicate that your specific brand of BCP was causing breakthrough bleeding for you. All that is due to the hormones in the BCP and does not reflect on your fertility.

However, given that you stopped the BCPs in October 2011, one would expect you to have resumed a " normal for you" menstrual pattern within three to six months (at the very longest). Therefore, the problem is definitely a concern since April 2012.

It is a little unclear to me if you had a history of very irregular periods before age 19 when you were started on BCPs. If that is the case then the current missed periods are actually a reflection of your "normal for you" menstrual pattern.

You are correct, it is VERY difficult to calculate ovulations and peak fertile times when one's cycles are very far apart or irregular. As you may have read, the most common cause of a missed period is not having ovulated that cycle.

In a normal cycle, estrogen is produced all month. Estrogen is responsible for building up the lining of your uterus so you have something to shed each month. In a normal cycle, progesterone production increases following ovulation. Progesterone "stabilizes" the uterine lining in preparation for a possible implantation of a new pregnancy. If you are not pregnant that month the levels of estrogen and progesterone fall, triggering the release of the uterine lining—your period.

So, if you do not ovulate, the estrogen build up of the lining continues, but without the usual ovulation associated progesterone. Thus, the hormone levels don't decline, and the lining stays up inside the uterus—your missed period.

If you have been several months without a period, a gynecologist may give you some progesterone in a pill form (eg Provera 10 mg for 5 days). Within 48-72 hours after stopping the progesterone your "progesterone blood level" will fall, triggering the release of the lining that has been building up. Many women report that these periods are very heavy-- as though several months of lining are shed.

Causes for not ovulating are multifold: thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with spouse, money worries), increased body weight, anorexia, rotating shifts at work, etc.

Given that you are trying to conceive, AND have not had a flow since late February, it is time to see a GYN or your local family planning clinic. They can prescribe some generic Provera to see if any lining in your uterus will be shed. They can do a couple of simple blood tests to look for low thyroid or elevated pituitary hormone are present. They can also assess if there is a discernible reason why you are not ovulating regularly.

Even if you are ovulating very irregularly one can still conceive before the next flow arrives. So keep trying to conceive, it can happen as a surprise.

Yours,
Jane