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Have irregular periods, done hormonal test, prescribed Mertap. Again irregular periods. Please advise

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hi doc, XXXXXXX here, i hve been getting regularly irrigular cycles for the last 1yr. 7months ago i got hormonal tests done, all are results are normal. durin oct'11 my doc game 'mertap -10mg' course of 5days to get the periods. later for 3 months it was nomal. again it stopped in jan-feb '12. pls advice .
Posted Sat, 11 Aug 2012 in Menstruation and Miscarriage
 
 
Answered by Dr. Timothy Raichle 17 minutes later

Hello, I would be happy to help you with your question.

What you are describing is "anovulatory cycling". Mid-cycle, women ovulate (produce and egg). If the egg is not fertilized, then there is a predictable withdrawl bleed afterwards. In your case, there is obviously extreme variation in terms of when you ovulate.

In some cases, women who do not ovulate do not get a period. In this case, they sometimes need medication to "start" a period. This is what they did in your case, which worked, but now you have fallen back into an anovulatory pattern.

It sounds like they did testing that was "normal" and should have included tests for thyroid disease, diabetes, and measurement of a hormone called prolactin (at the least).

If you are not trying to get pregnant, then birth control pills are most often used to regulate your cycle. If you are trying to get pregnant, then medications to force ovulation are used (one is called clomid).

I am hoping this answers your question. If it does, make sure that you accept and review the question so that I can get feedback from you! If you have more questions, please ask!!
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Follow-up: Have irregular periods, done hormonal test, prescribed Mertap. Again irregular periods. Please advise 23 minutes later
thanks doc ! pls give a list of tests that i need get done ..
 
 
Answered by Dr. Timothy Raichle 4 minutes later

In the workup of anovulatory bleeding you need:

1. TSH, free T4 and free T3
2. Prolactin
3. Fasting glucose, fasting insulin (your doctor can interpret the ratio of these two)
4. An ultrasound to look at your ovaries and uterus
5. LH, total testosterone, and DHEAS

I hope this helps, please provide feedback! Good luck!
Above answer was peer-reviewed by
 
Follow-up: Have irregular periods, done hormonal test, prescribed Mertap. Again irregular periods. Please advise 5 minutes later
.. 'In the workup of anovulatory bleeding you need:'

does this mean during the 3-5days of bleeding time ?..

thanks..
 
 
Answered by Dr. Timothy Raichle 10 minutes later

No, this can be performed at any point during your cycle. Ideally, the prolactin level would be checked fasting.
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