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dsmith4242 posted:
I was wondering if I still ovulate without getting my period. I am trying to get pregnant but i have a very irregular peiod. I was on the pill for about 3 years and have been off for about 10 months. I have not had my period for 4 months and have only had it once in the past 8.... HELP
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Jane Harrison Hohner, RN, RNP responded:
Dear dsmith: The most common reason for the menstrual pattern you have described is not having ovulated that cycle(s). 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(s). It is possible to have a bleed without an ovulation for when the lining gets too built up, it can begin to shed on its own. It is also possible for a woman to have an ovulation and get pregnant before her next, "natural" period arrives. So continue trying to conceive--happy accidents happen.

Usually, 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.

There can be MANY causes for not ovulating: low thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with spouse/ boyfriends/girlfriends, finances), increased body weight, anorexia, rotating shifts at work, etc.

I would really urge you to see your GYN or local family planing clinic. They can give you an inexpensive, generic version of the Provera pills to see if your four months worth of lining can be shed. You should also ask them directly about any risk factors for infrequent ovulations. They can test you for low thyroid, if indicated. If you have been trying to conceive for nearly a year you may be a candidate for an ovulation-inducing drug (eg Clomid).

Best wishes on conceiving soon.

Yours,
Jane


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