Have come off the pill (microgynon) but no bleed. Does that mean I'm in menopause and how would this affect ivf please?

[Music1]

Hi all, I was advised by my fertility clinic to go on the pill as I have quite extreme pain every month after being diagnosed stage 4 Endo following a lap 7 years ago. The clinic said "if you go on the pill and take a break you will have a bleed the week that you take off. This way we can monitor your cycle for when you start any treatment". I've been on the pill since Jan and waiting for my TSH Thyroid to fall below 1 to start treatment for over a year. Now I've noticed, in the 2 times I have stopped the pill I haven't had a bleed twice. No bleeding nothing. I've gone from feminine towels to panty liners and even those haven't been needed. No bleed twice now. Does that mean I'm on the menopause or ? I'm 44 and am waiting to have frozen embryos put back but am worried if my body can no longer make estrogen by itself if I do happen to get pregnant? Any ideas please. I am hypothyroid and on 100mg of levothyroxine. Many thanks x

[Jmaw]

Hi Music1. I’m 46 and that’s what happened to me last year. Had last (extremely light) period last May and absolutely nothing since. We had to use donor eggs because I stopped ovulating as well. Blood tests showed I was pre-menopausal. But looks like you may have only just started this process, so ask for a blood test from clinic or GP for your hormone levels. Good luck xxx

[Music1 in reply to Jmaw]

Thank you so much for your reply. I will ask the clinic or GP for hormone levels next time I go. Did you have any success with donor eggs, and do you have to be on HRT whilst you're having ivf or after a transfer please? Thank you for your reply. I figured this might be the case. I've been wearing feminine products 'just in case' and nothing. I'm 43. x

[Saya85]

Hiya 🤗

Ahh i didn’t realise your age so yes that could be part of it... however with thyroid and Endo issues it could just be absent periods especially after coming off the pill as it’s synthetic hormones they give you. Not unusual to have changes to your cycle.

Also sometimes it can take longer to have withdrawal bleed(over 7days). Have you taken breaks for 7 days between packs?

How long since coming off the pill this last time?

I would not mention menopause to your GP! Given your history with her- you really do not want to give her another excuse to fob you off. Hormone testing st this point may not be useful especially because they can’t track where you would be in your cycle. I would discuss with your fertility clinic first. Get answers /advice from them.

However don’t worry too much about it affecting your ivf. You might find your thyroid actually settles better without the pill! As fake hormones can really play havoc.

If you’re not responding to microgynon they will most likely give you provera /norethisterone to start a withdrawal bleed to kickstart ivf when the time comes.

I don’t have natural periods anymore and it doesn’t matter for the ivf process as it will be medicated FET for you.

If you’re not having endo pains etc then you prob don’t need to be on a longterm pill anyway. They will likely give you higher dose of oestrogen during the frozen transfer to build lining and then you should be given higher doses of progesterone once pregnant (and of course thyroid dose adjusted immediately)

Best of luck x

[Music1 in reply to Saya85]

Starting to feel really OLD Saya. I wasn't going to post my age, but I feel a bit 'ripped off' if my body is going through pre-menopause, although I vaguely remember my mum going through the same. I still get terrific pain from Endo each month, even on the pill which is probably a bit strange? It's been 6 days since I stopped and nothing. I've always taken the 7 days between packs but the last 2 breaks I've had nothing. Maybe I'll leave it more than 7 days (10 days?) and see what happens?

Actually, I think you're right. I won't mention anything to my GP/locum. I went to her only a few days ago asking why my TSH was fluctuating so much and on the increase again. She just said "I don't know". Great appointment. You're an absolute star Saya. Gosh, I wish you were my GP I will mention it to the clinic and see what they say. Glad to hear it doesn't matter for the ivf process. Was beginning to worry. You wait for your TSH to drop and your period drops out instead.

Thanks so much for reassurance and wonderful info. Best wishes x

[Jmaw in reply to Music1]

Hi lovely, the donor eggs were unsuccessful I’m afraid and that’s with the donor only being 24! I’ve had 2 children naturally so had no problems before, so with me it’s definitely my age! They will probably give you short protocol because your periods have stopped. The cycle is so much shorter 2nd time with a donor. But first time lengthy especially if you are doing an egg share with another couple xxx

[Music1 in reply to Jmaw]

Hi, I'm actually using FET this time using donor eggs in all honesty. I did try ivf using my eggs 3 times but it failed twice and I had a miscarriage on the 3rd. I don't have any choice. I guess this is the price I pay for waiting so long for my 'Mr right' to come along and focusing on my career in the meantime. So pleased you have 2 children x

[Saya85 in reply to Music1]

Lol, exactly what I anticipated from your Gp. Now give her the chance to blame your infertility on the menopause and no chance of any help. You can ask about hormone tests later- maybe get guidance from clinic about which tests.

Hmm that is unusual re: endo pain. Have you tried taking magnesium supplements esp leading up to your period? They can be brilliant for period cramps. I find I get a lot of abdominal pain also around period time. Magnesium is brilliant for that.

But if it is true endo pain then have you considered a laparoscopy again to remove any endo? That could be affecting your chances too. If it was 7 years ago you may need another. But given that your not bleeding anyway unlikely to be endo tissue that’s growing elsewhere as it would happen same time as lining developing (but do check that out).

Lol everyone keeps telling me to retrain as a gp.. I think I’m too old for that now- plus not sure I’d get far in the current system.

Would love to be a functional medicine nutritionist though- best of both worlds.

Keep at it! If tsh is below 2.5 ivf is fine to start. But I would try and get to about 1 if you can. Get clinic to increase your dosage if Gp doesn’t

[Jmaw in reply to Saya85]

Yes Saya, they probably will give her Provera, that’s what they gave me. Also could be better plan seeing clinic first as they don’t understand ins and outs of fertility stuff like clinic does x

[DianeArnold Partner Nurse Fertility Network UK]

Hi Music1. Hopefully it's just a delay, as it can take a few months to get back to what is a normal cycle for you. Once you bleed you could ask your GP to check your hormone levels if you're worried. Good luck! Diane

[Music1]

Thank you Diane. I've just been trying to figure this one out. Really appreciate your advice. Best wishes

[Ash2016]

It took me 60 odd days to get my period when I came off microgynon. Hopefully it’s just the after effects of taking the pill.

[Saya85 in reply to Ash2016]

Yes it definitely can. Also they’re supposed to check your folate and B12 levels after coming off the pill as it can mask deficiencies.

Good luck getting to suggest that themselves !

[Music1 in reply to Saya85]

Haha, Saya I may as well have my GP apts in front of a cardboard cut out. Will keep you posted x