WOMENS-HEALTH Messages for February, 1998: Re: Amenorhea

Re: Amenorhea

From: Laurie Lovely, M.D. (anonymous@obgyn.net)
Fri, 13 Feb 1998 06:55:59 -0600 (CST)

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In reply to: Christie: "Amenorhea"

At Thu, 12 Feb 1998, Christie wrote: >
>I had twins via c-section in Sept. 96. In early Nov. 96 I spotted for
>2 days when I got my first depo-provera shot. My last shot was in April
>97. I stopped breastfeeding in July 97 as well. I have never had a
>"period" since the spotting in Nov. 96.

Depo-Provera can stay in your system for months, causing it to be nearly a year before your cycles start again.

>
>We have tried to "force" periods with provera 3 times (the last regimen
>preceeded by 21 days of estrogen).

This makes me more concerned that you might have scar tissue within the uterine cavity, because most people will bleed when given estrogen followed by Provera. The best way to diagnose this is a dye test done in the X-ray department. The test is called an HSG.

>The only other factor that may be an issue is what my dr. told me was
>endometritis (a severe infection) after my section that left me in the
>hospital for 6 days.

This is a very strong risk factor for the development of scar tissue within the uterus. This scar tissue can prevent periods and prevent pregnancy. Fortunately, it can be successfully treated and result in future pregnancy about 85% of the time. The treatment consists of hysteroscopy (looking into the uterine cavity with a telescope-type instrument) and direct cutting away of the scar tissue. This procedure is done on an outpatient basis and usually causes very little discomfort (period-like cramping). >
>I am very in tune with my body and knew exactly when I ovulated. I am
>almost certain I am have had three "cycles" in which I ovulate because
>of the "signs" of ovulation such as slight middle pain and mucous
>discharge.

This is also consistent with scar tissue within the uterine cavity. The condition, by the way, is known as Asherman's Syndrome.

I'm very frightened that we may not be able to have >any more children in the future.

I hope this information proves reassuring to you. I really think you should ask your doc for an HSG. If your physician isn't comfortable with that or with the hysteroscopic resection procedure, you should ask for a referral.

Best wishes to you.

--
Laurie Lovely, MD
RE fellow, UNC-Chapel Hill

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Previous message: Laurie Lovely, M.D.: "Re: Estrogen & testosterone pellet implants"
In reply to: Christie: "Amenorhea"

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