Monday, April 7, 2008

State of the uterus, cycle 2

It's time for another "Good News, Bad News:" *

Good news : I'm pretty sure I ovulated this month (although I didn't last month).
Bad news : it happened on day 24, which is way late. Normal would be more like day 14-16

Good news : My cycle this month was 31 days, which is well-nigh normal (down from 35 days last month).
Bad news : That means there were only 7 days between ovulation and my period starting, which, well, ack. Even if I had gotten pregnant, it almost certainly wouldn't have stuck. **

So. Where I seem to stand at the moment is that things are improving, but things are clearly still awry with ye olde hormones. After much wrangling, I got my doctor to increase my metformin dose,*** so hopefully that has helped with the normalization and as I spend more time on it, will help things improve further.

An supplementary theory is that this is my hormones normalizing after the iud removal and it's just taking a few cycles to crank up to normal. The problem with that is that my previous experience with hormonal birth control is that going off of it has a carryover effect for several months where my cycles are more normal, then start to get weird as my naturally screwed up hormonal state asserts itself. So coming off of it so badly this time isn't reassuring.

More wait and see, I suppose. Hopefully cycle 3 will show more improvement. And I'm starting to think about how soon I should to call the ob/gyn and ask for a referral to someone who specializes in infertility. She had said six months, which would technically be May. I think I may wait for June or July, since that would be six full cycles, not just six months since the iud was removed.

*With apologies to Animaniacs

**Quick primer for those unacquainted with ins and outs of the female cycle: it takes several days for the egg to meander its way down to the uterus through the fallopian tubes. Fertilization actually happens in the fallopian tubes, and the fertilized egg then hopefully enters the uterus and implants in the lining of the uterus, which is when pregnancy happens. But if there's not enough time between ovulation and period, the fertilized egg enters the uterus and surprise! Either doesn't have a lining to implant in or doesn't have time to implant properly before getting swept out to sea, so to speak. This is called a short luteal phase.

*** And this is the last time I go to my gp for anything for PCOS - I'll either call my ob/gyn or ask for a referral to an endocrinologist. First, she insisted on blood tests, but tested only one hormone which is typically found at normal levels in women with PCOS. But as it turned out, there wasn't much point to that, because when I pointed this out and told her the tests she should have done, she said that even if we did them, she didn't want to increase my metformin because she was afraid it would lower my (currently normal) blood sugar. And then she said that PCOS doesn't cause weight gain.

That sound you hear would be my jaw hitting the floor. Weight gain is one of the biggest features of PCOS, to the point that thin women with PCOS have trouble getting diagnosed. It's number three on the symptom list, behind not ovulating and polycystic ovaries. And the worry about lowering my blood sugar is just moronic because metformin doesn't cause low blood sugar unless you're diabetic, which I'm definitely not.

I finally pointed out that I've been on a higher dose before and didn't have a problem and she suggested we try it for six months. But yeesh. Not going back to her for anything more complicated than hay fever or an ingrown toenail.

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