Suggest treatment for premature ovarian failure
premature ovarian failure.
Thanks for the query to hcm,
From your history it is evident that as you have stopped producing hormones and if your FSH &LH levels are high and you have been amenorrhoeic since last 2 years then you have experienced a premature ovarian failure or POF. However there was a possibility that you may have been eating oestrogen foods like alpha sprouts, tofu, flax seeds in your diet which caused the endometrium to grow and once you were placed on progesterone 100mg /estra 1.5, likely that you may have mistimed your pills and that initiated a withdrawal bleed which was hence heavy and had clots. Ideally a ULTRASOUND pelvis( transvaginal) is a mandatory investigation in your case and hormone supplementation should be stopped and a dilatation and curettage should be done ( or an endometrial curettage for histopathology ) to rule out any atypia with endometrial hyperplasia which may be indicative of any cancerous changes. However the age is not conducive for the diagnosis but there is a probability as this bleed shall be anyhow taken as a post menopausal bleed and endometrial cancer may be a differential diagnosis.
I am not sure of you have a family history of POF or endometrial cancer in your maternal family which may explain the incidence if detected, but the line of management shall be as above to investigate the cause.
The present bleeding is due to the HRT withdrawal, yes. But the clots indicate a thick endometrial lining which cannot form in just 5 days so i requested you for an ultrasound pelvis before an endometrial curettage. Will that be possible for you to upload your hormonal profile report and an ultrasound pelvis if done , for perusal?
we can then wait for the reports.
Fine, not a hassle. As you have already undergone the biopsy then we should wait for the report and then we can make a decision. I am not sure why you should be on HRT when you have been asymptomatic.
Anyhow, please revert back with reports.
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