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Diagnosed With Endometriosis, Have Painful Periods, PMS Symptoms, Taking Conception Supplement. Could Diet Change Delay Periods?

Posted on Sun, 22 Jul 2012

Question: I have been diagnosed with severe endometriosis - one endometrioma of 7cm on right ovary, one of 5cm on left ovary and several endometrial nodules behind my uterus. All my life I have had very painful periods and bad PMS with symptoms for up to a week before menstruation, cramping especially bad 1 and 2 days before bleeding starts. This cycle I have significantly changed my diet - gluten free, dairy free, no refined carbs, no meat other than organic chicken once a week and oily fish twice a week, in order to try to manage symptoms and hopefully reduce the size of these endometriomas in order to conceive. I have also started taking a conception supplement as my husband and I would like to start a family. I have been on this diet for 4 weeks. My period is now 5 days late and I have not had any of the usual premenstrual symptoms. I was out of the country at my time of ovulation for this cycle so should not be pregnant, a pregnancy test has confirmed this. Could the change in diet have delayed my period? Will a lack of period mean I cannot conceive in my next cycle? If no, how will I know when I ovulate if I cannot count from my period (I usually have very regular cycles). My day 21 bloods for this cycle showed that I did ovulate.

Answered by Dr. Rhea Chanda (52 minutes later)

Hello,
As im sure you've been told,fertility is affected in endometriosis.The degree of affection depends on the severity of the disease.In my opinion,the endometriomas need to be removed.The sizes you have mentioned are large enough for surgical management.As far as you cycles go,if you are late and the pregnancy test is negative then any hormonal imbalance can delay the cycle.Since you have mentioned that you were out of the country during the fertile period,that's the best conclusion.Since you have missed this cycle,then your ovulation wont occur at the usual time.It is my opinion that you need to undergo intensive management and ovulation induction with medicines/injectables if you havent already provided all other tests are normal.Wait for a week more and repeat the pregnancy test.If negative,then your doctor can give you medicines for your period to come.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rhea Chanda (7 minutes later)

Thank you. All blood tests have come back normal, my AMH level is good for my age and day 21 bloods show I am ovulating naturally - I have not yet had an ovulation induction. I have agreed with my gynaecologist that I will attempt to conceive naturally for 6 months, improving my diet and having acupuncture at the same time. During this time I will also have regular ultrasounds to monitor the endometriomas. If there are any negative changes we might change the plan. If I have not conceived after this time then we will reconsider options (surgical intervention or IVF).

I have been referred for an HSG X-ray to ensure there are no blockages in my tubes. I was told this should be done on day 7 to 10 of my cycle. Again, given the lack of period this cycle, what do you recommend in terms of timing for this test? Many thanks

Answered by Dr. Rhea Chanda (11 minutes later)

Your plan is feasible.The HSG is a correct option and if you are having natural ovulation then definitely try to conceive naturally provided the HSG report is good.
The HSG should be done right after menses(as recommended to you) and for that if you will need to have your period. As i suggested ,wait for a few days and if you still havent got it,then you can get withdrawal bleeding with medicines.

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar