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Negative beta HCG test, have PCOD and thyroid problems, delayed periods. Prescribed Meprate. What to do?

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General & Family Physician
Practicing since : 1979
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Hi, I had my last period on 7th July'12. I didnt get my periods in August. got Beta HCG test done on 10th Aug which is negative. I have PCOD and thyroid problems. I was advised meprate 10mg for 5 days. 5 days are over after the last dose. I still didnt get my periods. What to do now?
Posted Fri, 7 Sep 2012 in Menstruation and Miscarriage
Answered by Dr. Chandra Shekhar Sharma 42 minutes later

Welcome to XXXXXXX

Menstruation/period generally starts on 14th day of ovulation. You were prescribed meprate probably to induce withdrawal bleeding.

Patients suffering with Poly cystic ovarian disease have multiple small cysts in their ovaries.

Thus, Ovaries become enlarged and produce excessive amount of estrogen and androgen hormones.

This results in anovulatory cycle, and absence of ovulation causes infertility.

Many patients with PCOD also have insulin resistance and have raised level of insulin.

These patients may not respond to clomiphen, thus treated with anti diabetic drugs like metformin and troglitazone.

Clomiphen is used to stimulate ovulation. Low doses of dexamethasone can be given simultaneously to suppress androgen production from adrenal gland.

If clomiphen doesn't work, a new anti-estrogen called Letrozole can be used.
Clomifen resistant women suffering with PCOD, may need HMG(gonadotrophis) to induce ovulation.

Difficult patients may require a combination of GnRH analog and HMG to induce ovulation successfully.

Metformin can improve your fertility by reversing endocrine abnormality and improving your ovulatory response.

You can conceive, provided ovulation occurs and you have sex around ovulation day.

You should consult an experienced Gynecologist to examine and find out cause of delay, and take treatment for PCOD/PCOS, and consult physician for hypothyroidism.

Thanks for trusting XXXXXXX and posting your query.

Hope you found my response to your query informative and helpful.

If you have further concerns in this regard, I would be happy to discuss those with you as well.

With good wishes,

Dr.Chandra Shekhar Sharma
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