Delayed Period After Depo Injection Discontinuation: What to Expect

Question
Hiya, I'm writing from London, England. I discontinued my depo injections in Feb 2009, after around 4 years on them. I had previously used depo and my periods returned within 5 months of last injection. This time round I am yet to have a period and it has been around 15 months. I have tried Northeristone but did not get a withdrawal bleed. I have been referred to a gynaecologist but as yet all they have done is take my blood and tell me to come back in 3 months. It's very frustrating and I really want to know what might be wrong with me and how to fix it! Everything I read tells me periods should return within a year or so, so I can't help but think there is something wrong with me which was masked by my depo injections. As I am 32 I don't want to wait much longer, and am also concerned that even if my periods restart it will take me ages to concieve.

Any suggestions or help you can offer would be appreciated.

Sarah

Answer
Hello Sarah from the U.K.,

I agree that something is not right, and am appalled that you have to wait 3 moths for the test results.  That is a crucial piece of information.  At this point I would be worried that your ovaries are not functioning for some reason.  One possible cause is called premature ovarian failure (premature menopause), and the blood test will tell that immediately.  In my office, we do the test so the result if given to patients within 30 minutes.

You lack of response to progesterone is a sign that you did not create and endometrial lining, which means there was a lack of estrogen.  My usual next step is to use a birth control pill, 3 times per day for 7 days to induce the bleed.  This confirms that the uterus is working properly.  With that and the hormone tests, we can then determine what the next step or treatment would be.  I know you have limitations in the U.K. because of the NHS, but you should insist on being seen ASAP, or find a doctor that will see you soon.  Given proper treatment, by three months you could be pregnant!

Good Luck,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf, and follow me on Facebook at http://bit.ly/9Iw9oV