Infertility and irregular periods..A MUST READ

Firstclaas newsline special~the menstrual cycle, which is counted from
the first day of one period to the first day of the next, isn't the
same for every woman. Menstrual flow might occur every 21 to 35 days
and last two to seven days.
For the first few years after menstruation begins, long cycles are
common. However, menstrual cycles tend to shorten and become more
regular as you age, with an average of about 28-30 days in most
females.
Your menstrual cycle might be regular – about the same length every
month – or somewhat irregular. Your period might be light or heavy,
painful or pain-free, long or short, and still be considered normal.
Within a broad range, 'normal' is what's normal for you.
When the period comes more frequently than normal, it is referred to
as Dysfunctional Uterine Bleeding and it can be a major cause of
infertility. If the woman is bleeding constantly, infertility can
happen simply because the couple will not be able to have regular,
timed intercourse.
For example, I once had a patient, married for six years without
getting pregnant, whose period lasted for 17 days, though the period
was not heavy, and it created a problem because it made it impossible
for her and her husband to have sexual intercourse. The period would
go on for days, clear up for a few days, only for the spotting to
start again. This is a case of dysfunctional uterine bleeding.
Dysfunctional uterine bleeding occurs in about 70 per cent of women,
preventing the release of an egg (ovulation) which occurs during
normal menstrual cycle. Their irregular periods are due to a hormonal
imbalance between oestrogen and progesterone. This is a very
significant cause of infertility, making up to 10 per cent of the
causes of infertility.
A woman's menstrual cycle is controlled by two hormones – oestrogen
and progesterone. The levels of these two hormones vary during the
month. During the first half of the month, oestrogen is high, so as to
stimulate the growth of the uterine lining which is called the
Endometrium, to produce egg.
When the egg is ready for fertilisation around the 14th day,
progesterone rises and causes changes in the endometrial lining to
prepare it for pregnancy. If the egg is, however, not fertilised, the
progesterone levels fall and the unfertilised egg is shed in the
monthly period. If oestrogen levels are abnormal, there will be no
production of eggs. This will also disturb the production of
progesterone and therefore the periods will be irregular.
In cases of irregular periods, even when a couple has intercourse
during the times that the woman should normally be fertile, there may
be no eggs to be fertilised, as she is not producing any.
Dysfunctional Uterine Bleeding is also caused by many other factors
such as Polycystic Ovary Syndrome, which are cysts on the ovaries.
Women who are on dialysis, or those using an intrauterine device for
birth control, may also have heavy or prolonged periods. Other factors
include endometriosis, uterine polyps, uterine fibroids, sexually
transmitted diseases, and medications, e.g. birth control pills,
hormonal agents, Warfarin (Coumadin).
Most young girls will have irregular periods when they first start
menstruating, but by age 20, their periods should have settled down to
the normal 28 to 30-day cycle. By the time most women are 45 years old
and are approaching menopause (premenopausal state), they will also
have irregular periods until their period finally stops by the time
they are about 50.
Most perimenopause may not actually be producing any eggs, even when
they have their periods, because of the irregular rise and fall of the
two hormones oestrogen and progesterone.
When a patient comes to the clinic complaining of abnormal period, one
must first rule out all causes of such bleeding such as cancer,
infection or pregnancy before one can make a diagnosis of
dysfunctional uterine bleeding. The doctor would do an ultrasound scan
of the pelvis and other evaluations to rule out abnormalities of the
uterus like fibroids or small polyp growth, which can also cause
bleeding. The doctor will then perform hormone measurements of the two
hormones oestrogen and progesterone, which control the menstrual cycle
and the production of egg.
After ensuring that the dysfunctional uterine bleeding is caused by a
hormonal imbalance of oestrogen and progesterone, the patient can then
be placed on a three-month course of birth control pills.
When birth control pills are given to a woman for an abnormal
menstrual cycle, they will supply progesterone and oestrogen in the
right amount at the right time of the month and thus artificially
induce normal production of the egg during the month and normal
shedding of the endometrial lining, leading to regular menstruation at
the right time in the month.
This treatment will provide for regular periods and the normal
production of eggs in the ovaries. A woman undergoing such treatment
can expect to get pregnant after being treated with the birth control
pills for at least three months.
The use of bio-identical hormones, which are developed from plants and
have been refined to such an extent that it can be absorbed through
the skin rather than taken orally, thereby sparing the liver from
damage, can also be used instead of the pill for the regulation of the
menstrual cycle.
Firstclassnewsline.net