Why are my lady parts so stupid?
June 21, 2012 3:54 PM   Subscribe

My monthly cycle has become crazy, right as I'm trying to get pregnant. Help me figure out what is going on and what to ask my doctor.

My husband and I moved to a new town in November and started trying to get pregnant with our third child. (The first two were conceived while on birth control.) I've been using the method from Taking Charge of your Fertility but I haven't been good about taking body temp. I get a sharp pain during ovulation so that helps with timing.

I got pregnant the first month but had a miscarriage around week 5. I don't know if it might be relevant, but my hcg levels kept rising after the (suspected?) miscarriage and I was diagnosed with an ectopic pregnancy around what would have been week 8, despite nothing being visible on any ultrasounds. I was given a shot of methotrexate and my hcg levels quickly fell.

That was in early January. Since then, my cycle has been crazy. The first one was 35 days, just like normal for me. And then I didn't have a period for three months. We kept hoping I was pregnant but blood tests confirmed I wasn't. Around the second month, I had really sharp pain on my lower left side for two or three days, similar to ovulation pain but a hundred times worse. I went to the doctor worried about a possible ovarian cyst, but she just shrugged it off and told me I was fine and sent me home without checking anything. They offered me some drug to help jumpstart my period after the third month, but then it started naturally before I took the drugs.

Then there were two normal 35 day cycles again. Now I'm 8 days late and a hpt confirms I'm not pregnant. My weight hasn't been fluctuating (although I am about 40lbs overweight), and I haven't been under much stress. I eat well, I don't get enough sleep, I'm tired a lot. I feel crampy and/or nauseous randomly throughout the month.

I know this is more than you've ever wanted to know about my bodily functions, but every doctor I've seen since moving here has been worse than the last...talking over me, not answering questions, apathetic, rude. My doctor tells me just to wait it out or take drugs, but I would like to get to the root of why my cycles are all over the place now when they were always like clockwork before. I want to know if something's wrong with me and, more than that, I want to get pregnant.

Can anyone give me any insight into what might be going on with my body? What specifically should I ask my doctor? What tests should I ask them to run?
posted by anonymous to Health & Fitness (17 answers total)
I am wondering if you moved to a substantially higher altitude. That can mess with your cycle.
posted by Michele in California at 4:00 PM on June 21, 2012

1. It could be wonkiness from the miscarriage, even months later.

2. from my own experience in this area, what you want to ask your doctor for is a referral to a an OB/GYN or reproductive endocrinologist who specializes in suboptimal fertility cases.
posted by KathrynT at 4:05 PM on June 21, 2012 [4 favorites]

Could it be perimenopause?
posted by squeak at 4:14 PM on June 21, 2012 [1 favorite]

Research PCOS.
posted by MeiraV at 4:22 PM on June 21, 2012 [1 favorite]

When my husband and I started trying to get pregnant, my previously written-in-stone cycle went completely haywire, and eventually i figured out it was down to excitement and stress. You may be having hormonal fluctuations due to ovarian issues or your miscarriage, but don't underestimate the effect stress (even happy stress) can have on your body.

I'm sorry your doctors haven't been particularly helpful. Would you be open to trying a more holistic approach? I'd see if there's a reputable naturopath in your area. Not all of them are into homeopathy and woo.
posted by Specklet at 4:22 PM on June 21, 2012

I empathize with how hard it is to take your temperature consistently (I do it too). As you know from TCOYF, though, if you can get a full chart put together, it would help you figure out whether you're delaying ovulation, not ovulating at all, etc. Barring that, yeah, fertility specialist if you can find one.
posted by synchronia at 4:28 PM on June 21, 2012

I think the miscarriage could be the root cause. Some woman are back on track right afterwards, some women take several months. Think back to your previous pregnancies, how long did it take for your cycle to return and return to normal afterwards? Each pregnancy is different but it might suggest a pattern to your cycle now.
posted by saradarlin at 4:47 PM on June 21, 2012

I don't know about the wonky cycle, but just in case you haven't been testing daily for ovulation, I highly recommend it. Ovulation test strips are cheap - I bought from this site but I think elsewhere on the web is even cheaper, try ebay - and it's so worth it to know exactly what your body is doing.

(In my case I turned out to be ovulating like around day 22-23 of my cycle, and some months I didn't ovulate at all. If I hadn't been testing every day, I don't want to think how long it would have taken me to get pregnant!)
posted by fingersandtoes at 6:23 PM on June 21, 2012 [2 favorites]

I'm so sorry you are having trouble. How difficult for you. I've found using ovulation prediction kits, taking my temperature, and keeping track of everything on FertilityFriend.com has been very helpful for me. Also, I recently switched from an OB/GYN to a reproductive endocrinologist and the amount of knowledge the RE has and the specialized testing they can do has been really impressive. I have been diagnosed with PCOS and I felt like my GYN just brushed me off and didn't take me seriously. I wonder, with your longer cycles, if you might have PCOS as well. Or maybe you have a totally different diagnosis, or nothing at all. I would go straight to the RE if you are able, instead of trying to get your current doctor to run tests for you. A good RE will know what to look for and which tests to run. And dump any doctor who you don't think listens to you. You know your body best, and the doctor should value that. Best of luck to you!
posted by k96sc01 at 6:43 PM on June 21, 2012

How old are you? You may want to have a blood test to check your hormone levels as well. I am sorry you are not finding a sympathetic doctor. I had a couple of great doctors while trying to get pregnant. Cycle seems to be normal, but you may want to get a HSG (hysteria-salpinography to see that there is nothing wrong with the fallopian tubes. That could cause strange cycles too. Did the doctors ever considered testing to see what actually caused the miscarriage? A friend of mine had problems with her thyroid (slight problems) but it was enough to cause her not to get pregnant. Perhaps a search for a fertility expert would be a better way to go. At the very least, they would have a better understanding of how you feel.

Best of luck.
posted by Yellow at 8:19 PM on June 21, 2012 [1 favorite]

My first thought before reading the question in full is that trying to get pregnant can cause stress which can equal wonky periods. When you factor in the miscarriage, your stress level would most likely increase. While not easy to solve, it could be as straightforward as that (stress hormones interfering with reproductive hormones), but you really need a doc to do a full blood panel, not just of reproductive hormones, but everything else, too. As mentioned above, thyroid issues can mess with your cycle and a number of other conditions can, too. Also, as trite as it may sound, good self-care can make a tremendous difference. Taking your vitamins, eating a nutritious diet, regular exercise, and getting enough sleep can have a huge impact on your cycle, your fertility, and just your overall well-being. If your doc rules out any reproductive or other medical issues, you probably just need to do your best to relax and take care of yourself. It sounds way easier than it is, of course, but it will help in all facets of your life. Good luck!
posted by katemcd at 11:37 PM on June 21, 2012

I don't think reproductive endocrinologist is a bad idea, but they typically do not see younger women who have only been trying for 8 months as infertility cases (especially considering you've had a pregnancy during that time already). Perhaps they will see you though to discuss the irregular periods, although this could be done with a regular OB/GYN. If you are older than 35, then yes to reproductive endocrinologist now.

p.s. my first clue I had PCOS was irregular cycles once I went off hormonal birth control.
posted by treehorn+bunny at 1:24 AM on June 22, 2012

After the suggestion by many Mefites that I try the Taking Charge of Your Fertility book, I found that it made me insane. I became worried about my body temp constantly, tried to time sex accordingly, and would absolutely freak out when my body was not displaying the signs that the book pointed to as a means to becoming pregnant. I bought the ovulation test strips, a thermometer, the whole nine yards and it made me absolutely crazy. The ensuing insanity of trying to see what your body is doing or even force it to do what you want it to in order to conceive could be throwing you off. After 5 months of trying to get everything just right, I threw out the book and the ovulation strips and wound up pregnant (I'm 26 weeks now!); (the one thing I was looking for that I took away from the book was keeping an eye out for cervical mucus [fluid]).

As for your OBGYNs, I would start over somewhere else. No one should be talking over you and ignoring symptoms, let alone shrugging anything off. Talk to your female family members and friends about who they go to and ask them why the like/dislike their doctor(s). I wish you the best of luck.
posted by ThaBombShelterSmith at 5:54 AM on June 22, 2012

PCOSer here.

Agreeing with just buying a bulk of ovulation test strips. Put a reminder on your calendar and test daily. Remember to hold it for about two hours before you test, test at or around the same time every day.

And yes, stress and previous miscarriage (I'm sorry) can really wonk with your cycle. All of my full term pregnancies were crazy late ovulations.
posted by tilde at 6:07 AM on June 22, 2012

I have PCOS and had irregular periods. I found that the stress of not having my period was contributing to me not having my period. It is so very frustrating when it's been 45 - 50 days and you keep peeing on strips and they keep saying 'negative' and yet you still don't bleed, dammit.

I was diagnosed when they did an ultrasound on my pelvis. This was a couple of years ago, but I told them that I had very irregular periods and when it was pushing 50 days, they told me to come in, gave me an exam, a blood test and, when both were negative, then sent me to get the ultrasound. (I think when they heard 50 days they originally thought I was pregnant and just too dumb to pee on a strip correctly.)

They prescribed progesterone for me and I took it for a few months but I don't like taking drugs (especially hormones and especially steroids) so I stopped.

What helps for me is a bout of heavy exercise and some good ol' sexual activity. Usually after one or the other, my body rebalances from the stress and my period finally arrives.

I've found that changing my job to a better, less stressful job and exercising regularly (including bouts of really exhausting exercise to help release those endorphins) has helped me IMMENSELY in getting my period to a normal schedule.

But this in no way is a substitute for medical advice.
posted by jillithd at 6:45 AM on June 22, 2012

Advancing age can be a factor in erratic cycles, and miscarriages really rock the boat hormonally. Your first two pregnancies happened while on HBC? That makes me think that since HBC was artifically regulating your cycle, it might have been *easier* to get pregnant. You might consider suplementing with natural progestrone cream, which can help regulate things without going big guns. It's 14 days on / 14 days off. My acupuncturist recommended this after a miscarriage and a bout of wonky cycles, and it got me standardized at 28 days within 2 cycles.
posted by mmmcmmm at 8:52 AM on June 22, 2012

After two years of infertility, my twin sister found out she was allergic to gluten. It didn't show up in her blood panel (common), however, what did show up was inflammation. After cutting out gluten for 3 months, she was pg with twins. Everyone's symptoms are different. Hers was was being itchy, all-over and mine was chronic fatigue/foggy memory. GL to you!
posted by vvbb at 12:38 PM on July 22, 2012

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