Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Lizab]

My understanding is that in a normal cycle, FSH tells the ovaries (?) to make estrogen, which leads to ovulation, which leads to production of progesterone by the follicle, the egg?, which leads to a period. So what causes a period when you don't ovulate?

I'm told that I had likely been having anovulatory cycles for some time, with the occasional ovulation thrown in. If my FSH is very high, am I producing loads of estrogen and there aren't any eggs responding? And it's taking 4-5 months to build up enough estrogen to cause breakthrough bleeding? What about very short two-week anovulatory cycles?

Suppression of ovulation to help with hormonal fluctuations has been mentioned a few times, but I know I'm not ovulating often, if at all.

[Briony]

Can't help you there, but am sure someone else can.

In general, the reason some of us in peri menopause aim to suppress ovulation is that it's the cause of our fluctuations. If you are not ovulating, I would assume your issues are more due to low estrogen than ups and downs? The reason Prof Studd, Nick Panay, NAPS recommend suppressing ovulation for severe PMS is that it keeps you on an even keel while still ensuring you have enough estrogen by 'adding it in' (whether by patch, implant or birth control pill).

Hopefully the link I sent you earlier explains it better than I can!

B

[Lizab]

Thanks, Briony. You're link did make sense, which led me to question what is going on with me. If I'm not ovulating, then I'm probably not fluctuating, and why do I feel more unstable on the estrogen only days? Am I still cranking out the estrogen, but since I'm not ovulating, producing no progesterone to counter an excess of estrogen? If that's the case, could I ditch the patches and take the 10 days of progesterone every now and then when I start feeling antsy?

What does the pituitary respond to for FSH production? Estrogen or something else?

[dogdoc]

It's a negative feedback loop. So low levels of estrogen cause increased FSH which prompts the ovary to start producing estrogen. At a certain point you get an LH surge causing ovulation. The area on the ovary ( the follicle) you ovulated from then produces increased levels of progesterone while the amount of estrogen declines. Progesterone drops which triggers uterine bleed. Repeat.

In peri both extra long and extra short cycles are more likely to be anovulatory. I can't give you a good explanation for short cycle anovulatory cycles. The longer ones are usually breakthrough bleeding from excessive estrogen without progesterone.

Many many clinicians believe in early menopause you do not need to supplement estrogen ( your making lots) but can take progestegin during the last 1/2 of the cycle which will change the uterine lining, and allow it to shed without excessive buildup ( caused by increased estrogen). Progesterone declines in menopause before estrogen begins to decline. It makes sense if you think you're not always ovulating ( therefore no progesterone) and when you do the corpus luteum ( the thing that makes the progesterone) might be kind of crappy at the job.

If you're lucky and not overly messed up by progesterone that is :S

When I took the progesterone it remarkably improved bleeding length and quantity and brought me back to a 'normal' 28 day cycle. Unfortunately coming off progesterone ( withdrawal) was horrific almost every way I took it.
Tara
 

[dahliagirl]

The FSH also causes the ovaries to make oestrogen.  When they stop, you get a withdrawal bleed.

If the lining builds up in the presence of just oestrogen, it does not become modified by the addition of progesterone (not sure how this happens - it is the secretory phase).  The progesterone changes the cells so that when your levels drop, the spiral arteries go into spasm and it comes away all together.  In the absence of progesterone, when it has built up enough, some of it will break away, with bleeding, until it mends, then some more will break away etc.  This is a breakthrough bleed.

Thinking about it, you probably get a mixture of the two types of bleeding.