Irregular - help

Hi

I hope this hasnt already but i couldn't access the links in the conception faq's post. Hope this post isnt too long, but would just like someone elses advise.

Ihave been off the pill since April 2005 and TTC, was on the pill for 7 years. i have had very irregular cycles ranging from 40 days to 120. I have also had sore breasts and cramps from the day i ovulate till i get my period which I never had before or during the pill.

I have had numerous blood test by my doc & gyno for hormone, glands, thyroid, blood sugar etc etc. The result being that my prolactin was slightly raised. She also told me i need to lose weight to be in the health weight range.

Anyone else have a similar prob or any advise?

Jewel

Hi Jewel

I have a slightly similar problem in that I get sore breasts from O all through my LP now and never did before, and also was on the Pill for around about 8 years (and as you shouldn't ovulate on the Pill you shouldn't see the O-side effects). I was about 5-weeks regular (3-7 weeks was normal) pre-pill and about 6-weeks regular now (though one 5- and one 8-week cycle to date, the other 4 cycles have been within 4 days of the 6-week mark). I'm now cd45 and still no sign of AF or even ovulation. This has been 10 months for me, as I came off the Pill mid-August 2005, and I'm beginning to think it's more than a "coming off the Pill" side effect, especially as the 8-week cycle was my last one. So, though I'm not yet TTC, I can sympathise (and can only imagine the stress of a 120 day cycle!).

I have had blood tests before, as I was concerned about having a prolactinoma, and everything has been normal so I'm off to see a herbalist tonight and going to have another blood test next Thursday if AF doesn't show (cd51 - I said I'd do it at 7 weeks and that's close enough to). Although I have normal/lower end of normal prolactins, I work with people who have raised prolactin so will give the UK guidelines, as I understand them (I'm a PA and my boss dictates quite a bit on this, so this is what he says, not what I've picked up at conferences and stuff, but I know he does a lot of work and study in this field).

UK Prolactin level guidelines and treatments

For non-pregnant women, prolactin should be 102-496 units per litre, however until the level of prolactin is consistantly over 1000 it's nothing to worry about (please adjust this for Aus values, but basically your prolactin can double the upper limit and still not be a problem: breastfeeding mothers can get pregnant and their prolactin is often above the upper limit). Also, make sure you have 2-3 tests as just one may show that you're over the limit, but you might normally not be. Prolactin can suppress the menstural cycle, but a small rise isn't usually considered significant. Over 1000 and the patient is sent for an MRI of the hypothalamus and the pituitary, which will show if there is a secreting nodule on the pituitary gland (the hormone master gland in the brain). This is not uncommon: I know I work with it so see all the cases, but it's not a really rare thing (ie my boss doesn't get excited when someone presents with this).

Excess prolactin can be treated in two ways - with drugs (usually Carbergoline) or with a transsphenoidal hypophysectomy, an operation to remove the growth. Drugs are usually preferred to brain surgery, as you can imagine! Carbergoline is phased in slowly, once a week, then twice a week, then the dosage upped... and so on until the excess prolactin has gone down. Then you're phased off the drug and usually you don't have a prolactin problem again, although if it continues to reoccur the surgery is the best option.

Remember, if you do have a prolatinoma, even treated, to mention this to your obstetric carers when you do become pregnant so they can keep an eye on you too.
As for weight, I believe that if you're fit and healthy the BMI can fly out the window, as can dress sizes. Very few healthy women will be outside the 10-14 range, you'll be told, but I'm a very healthy 8 and I know some healthy 16-18 girls too: the point is that not everyone can be waif-like and it is more damaging to starve yourself to be what someone else thinks you should be - even if that someone else is a doctor. If you eat healthily and exercise I'd not worry. If you find that by upping your exercise a bit and eating smaller portions you don't lose much weight then you're at a healthy weight for you.

Quite a few girls on BB use vitex to regulate their cycles, also Metformin (used for diabetes and PCOS) can help with weight loss, although it's not licensed for this. Hope some of that helped you and again, best of luck with TTC.

Hi

Thank you so much for that info, I think i will get another blood test done to check my levels again. My last 3 cylces have been between 5-6 weeks, so hopefully they are becoming regular. Just a long and frustrating journey. It has really put me off ever going back on the pill later, even if it wasnt that which caused the irregular cylces.

Thanks once again and all the best with your cycles too.

Jewel