Dr. Purushottam Sah
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,
My wife has periods issue. She was on birth control pills for about 3 years to get periods. We got married six months ago. She stopped them now as we pretty soon started thinking of having a baby. My doubts are will sex trigger periods? Is there any connection between these? Is there any other way to induce period?
She is 32 now and so we are little concerned. She also has a phobia of intercourse. When we address the issue with a therapist, I would like to know medically anything can be done to make her get periods. Once she is comfortable with intercourse then we will go down that path. Please suggest.
Hi,
Welcome to icliniq.com.
First, we should consider the reason behind the fact that she needs pills to get periods. Was she diagnosed with any hormonal problem?
If not then she has to do blood/serum tests. Hb % (hemoglobin), TC (total blood count), DC (differential count), fasting blood sugar, TSH (thyroid stimulating hormone), prolactin, testosterone, FSH (follicle stimulating hormone), LH (luteinizing hormone) and ultrasound of pelvis, to know the exact cause, depending on which medicines can induce periods.
Sex can trigger periods only if there is any psychological issue. But do not rely on this. Yes, medically a lot can be done to induce periods and ovulation.
Patient's Query
Hi doctor,
Thank you for your detailed answer. Can you help me to understand, how would sex trigger periods? I am happy to learn that there are multiple medical options available.
Other information is that she was prescribed Medroxyprogesterone for a month of use which induced periods after 15 days of use itself. The doctor asked her to stop and wait to see if she will get periods automatically. I will share some of the reports we have shortly.
Hi,
Welcome back to icliniq.com.
Sex can trigger periods only if there is a psychological issue. There are instances where psychological issues like depression/anxiety suppress menstruation by acting through hypothalamus which is controlled by higher brain centers. Sexual activity if pleasurable can alter the neurotransmitters and change the hormonal milieu.
As Medroxyprogesterone induced periods within 15 days of usage which rules out any uterine pathology and that she has normal estrogen status. Now things depend on the reports of the blood tests.
Patient's Query
Hi doctor,
I requested the reports from my wife's hospital. I am attaching that here, please review and help.
Hi,
Welcome to icliniq.com.
I have read and understood your problem (attachment removed to protect patient identity).
She has PCOS, hirsutism and weight gain. Her TSH is 2.630 which is normal, so weight gain cannot be due to hypothyroidism.
Testosterone 62 ng/dL (15-70) and insulin 26.8<25 are a bit higher and are related to PCOS. Balding, hirsutism and weight gain require some more tests as serum cortisol (morning) and lipid profile. These should be done at 8.30 AM – 9.00 AM after 12 hours of overnight fasting.
Medicines prescribed are fine and can be continued and the above two tests may provide more information.
Patient's Query
Hi doctor,
Thank you for the additional information here. I will get the remaining tests done.
So as a summary, if we would like to have baby at the earliest possible (which is the major concern), what is the road map? She is currently not using progesterone as it was prescribed for short term. Can we start progesterone again and observe ovulation time to intercourse? Please suggest.
Hi,
Welcome back to icliniq.com.
For pregnancy, you need to do your semen analysis.
For infertility, ask your wife to take HSG (hysterosalpingogram) x-ray to see the patency of the tube.
Progesterone can be given from day 16 to 25 of the cycle. But before that her ovulation has to be triggered by medicines like HMG (human menopausal gonadotropin), FSH, Clomifene etc. for that you have to see a gynecologist to decide the doses. Do not give progesterone before day 16 of the cycle.
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