Dr. Aditi Laad
Obstetrics and Gynecology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am a 37-year-old unmarried female, with no sexual activity. I have been experiencing problem in periods that I have got the period twice a month in the last month, without any pain, and scanty period. My FSH is 8.29 mIU/mL, LH is 7.69 mIU/mL, prolactin 7.6 ng/mL, testosterone, total 18.6 ng/dL, TSH ultrasensitive 4.470 mIU/ml. Usually my cycle is 35 days, with three to five days period, and I experience pain too. I am worried because I am getting married soon and becoming infertile. I want to have my own babies. I have attached my today's blood reports (third day of period).
Hello,
Welcome back to icliniq.com.
I have seen the reports (attachment removed to protect patient identity). Your hormone levels are normal. I would like to know more about your menstrual cycle. Is it this month or every month you are getting frequent periods? I would like to get you a ultrasound pelvis done.
Patient's Query
Thank you doctor,
It is only in this cycle I have experienced periods twice in a month, and very dark color periods. I will get the ultrasound done, is it any particular day of the period should I get the ultrasound done or can I get it done any day. I have been experiencing in-between period spotting earlier also. It has been 8-9 months back for which I got some tests done but everything was normal. Kindly find the additional tests I have got done within a week let me know if these are normal, do I need to still get the sonography done?
Hello,
Welcome back to icliniq.com.
Your hormone profile is within the normal range. You have nothing to worry about. I would also like for you to get an ultrasound pelvis done on day 3 of your next periods. Currently, I am not prescribing you any hormonal tablets as all reports are normal and this is for the first time that you experienced such menstrual problems. Take tablet Regulate (Norethisterone) 5mg twice a day for 21 days if same symptoms appear again. Keep a menstrual chart. I will start you on cyclical progesterone if your periods are irregular next month also.
Patient's Query
Thank you doctor,
What about my AMH level. Is it not high? Does it suggest PCOS? Actually, I am going to get married soon and I am a little worried about fertility.
Hello,
Welcome back to icliniq.com.
Your AMH (anti-mullerian hormone) level is 3.6 which is on the upper border range but it is not that high. Your rest of the hormone panel is absolutely in range. Ultrasound on day 3 of menses will give us a more broader picture to rule out PCOS. Even if you have PCOS there is no scare for fertility as we have a lot of methods nowadays to induce on. So just chill. I can see that your BMI (body mass index) is also normal. The main treatment in PCOS or any hormonal condition is to improve lifestyle, diet modification, avoid junk, eat healthily and exercise for about 45 minutes in the morning. Do not worry.
Treatment plan
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Obstetrics and Gynecology
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