Regular cycles with PCOS?

IndoCyster · 12-28-2007, 10:43 AM

Can I have PCOS if I am having regual cycles on my own? My cycles are usually 29 days. My husband and I have been trying for 6.5 years and no luck yet. Went to the doctor today (day 12 of cycle) Doctor says my folicle is too small. So he is testing me for PCOS. Could it be that all these years I just haven't been ovulating? Thanks for any info. I am thin and have hypoglicemia.

Binxsmommy · 12-28-2007, 11:42 AM

I have "normal" cycles and do not O. The eggie cannot get out through my toughend ovaries. It is possible to have normal cycles and not O. But it is not possible to O and not have a period(unless your pregnant). Make sense? HTH!

peppagrl · 01-06-2008, 12:39 AM

If you are having regular cycles, you definitely must be 'O'ing. I have been having regular menstrual cycles (every 24 days on the dot) since I started menstruating until I chemically supressed them with Lupron recently. Other than that, I know I was ovulating because it was pretty regular. Therefore, I've been termed by my RE to have mild ovulatory PCOS.

Every time you have your period an egg leaves and the level of progesterone is low, estrogen is low, FSH and LH is low (from your brain). And as your period ends, your level of FSH and LH starts to rise. Your FSH gives you all the female characteristics by increasing your estrogen. (By the way PCOS is at the other end of the spectrum of menopause. PCOS is noted by elevated LH and Menopause is noted by elevated FSH).

At one point, your LH will rise signalling an egg to be released ready to be fertilized. And, so therefore LH will cause the egg to release progesterone elevating your body temperature (If you are temping, meaning measuring your temperature every morning before you leave the bed, you missed your opportunity to ovulate! You've already ovulated!)

You can try an ovulation kit just to make sure (pee on a stick). The Dollar Tree sells these things for a dollar of course. But, you'll need a couple of them to test at least 7 days after your period, but they will tell you exactly which day on the box to start. I did it just to make sure I do ovulate and it works! I was always Day 11.

That's why peeing on the stick is better than temping. If your pregnant your temperature would stay elevated). If the egg is not fertilized, your level of progesterone goes down and so it signals to your brain to decrease the FSH and LH and then you have your period. And, then your cycle starts all over again. Our hormones work like a whole see-saw mechanism, what made it go up must have been down. So you must ovulate!

If you have been ttc for this long, your RE or gyn will look at other factors (if it's not your) such as physical barriers, progesterone levels the cervical mucus, egg quality, etc. It sounds like your doctor may want to improve the size of the eggs and increase your progesterone level. Other women on this board with this experience or had this history may want to comment.

Jodes · 01-06-2008, 01:03 AM

I definitely know I've had times (years) of having pretty regular bleeds without ovulating. It IS possible that you haven't been ovulating - so hopefully you'll find out what's going on. I hope for your sake you don't have PCOS but it's not the worst case scenario either!

Also, to add to the last response, sometimes OPK tests don't work accurately for PCOS women because often our LH levels are always high - giving false positive surges. This the case for me at least, just FYI.

peppagrl · 01-06-2008, 02:50 AM

What's allowing you to have your periods? Ovulation! You can't have a regular period if your not ovulating.

If you have been having regular cycles (whether you have PCOS or not) you can try the ovulation kits or opk. They are designed to detect an LH hormone rise. However, if you don't have regular cycles the ovulation kits will not work. I'm saying not a variation from month to month, 30 days here 40 days there. It has to be on the dot or even off by a day or two (caused by stress!) On the box it will warn you saying 'if you have PCOS.' don't try , but you have regular cycles! What's the wrong in trying the kit?

My RE (is the chair of the Androgen Special Interest Group of the American Society of Reproductive Medicine) and a PCOS specialist. He recommended I do this and it worked. I first tried the test kits at day 7 after my period (one line) and each day until I got a positive (day 11 - two lines) and then a negative on day 12 (one line) and afterwards. On day 12, the level of LH is decreasing, but ovulation is occuring in that window between day 11 and day 12.

If you don't have regular cycles and you have PCOS you will test and test every day and will always have two lines.

Try the opks and let me know how it turns out. I do think there is something else going on and your doctor is looking into it. If you have PCOS (or another cause of infertility), then he or she may put you on clomid just to hyperstimulate your ovaries as well. Or even ovarian drilling. Some doctors, like mine, like to put women on metformin which will cause ovulation (which you have) but also to increase your progesterone levels of the egg. It also improves overall health for PCOS too!

If something else besides PCOS is the cause behind your probable infertility, just know as much as you need to know about your body and how it works. The more you know, the much easier it is to accept the diagnosis of the disorder and how to treat it. It took me some time to accept PCOS after learning about it in medical school and not even thinking it would be me at that moment. But, I said at least it is not cancer which my mother had, and at least it is not endometriosis (WHICH IS ANOTHER CAUSE OF INFERTILITY - 3D's dyspareunia (painful sex), dysmenorrhea (painful periods), and (dyschezia) painful bowl movements) which I have.

Just also know that everyone is different and there may be other causes behind their infertility besides PCOS. PCOS doesn't cause blocked tubes (infection (such as PID), adhesions, and endometrios implants may cause it), cervical incompetence, or low sperm count. Assuming your husband has already been worked up, your doctor will do a blood work of all your hormones just to eliminate a hormonal cause of infertility and get a chlamydia titer (a cause of PID - pelvic inflammatory disease). Then they resort to a more invasive test such as an hysterosalphingogram or even a laparascopy.

As you can see on this board, women with PCOS do get pregnant and they have tried various methods. Some women have even had sucess with Vitex (chaste tree berry) which helps with women at all stages of life with their hormones. Maybe you can consider it?

I'm going to do everything I can to have children in the future! Sounds like you are pretty determined too if you were ttc for 6 years! Don't give up and give it your all! At the same time learn! Take care of your body! And, relax (it happens to women whether it is PCOS or not)!!!

CAheather · 01-06-2008, 03:25 AM

I don't know - I'm very confused myself. I have regular periods every month, but I definitely have a lot of the other symptoms of PCOS (cysts on my ovaries, acne, hair growth, head hair loss, insulin problems) but I'm pretty thin and always regular with my period.

Up until about a month ago I would have answered that you MUST be ovulating, but now I don't know. I'm not sure I am, either. I am tracking my cycle for the first time with month and about to start my week of OPK to see if I'm ovulating...

Good luck to us both!

CAheather · 01-06-2008, 03:28 AM

here's a question I have - I've noticed that I normally get that egg-white cervical mucus halfway through my cycle. I always just assumed it meant ovulation. Do you ladies who have regular periods but not ovulate experience that, too?

AHoff01 · 01-09-2008, 03:46 PM

Quote:

Originally Posted by CAheather

here's a question I have - I've noticed that I normally get that egg-white cervical mucus halfway through my cycle. I always just assumed it meant ovulation. Do you ladies who have regular periods but not ovulate experience that, too?

I'd be interested in knowing that also. I'm not sure if I'm O'ing any longer and I haven't noticed EWCM, but I just started getting AF without inducing it, last month. It's odd, b/c I'm temping and I have the drop and rise, but I don't notice anything special about my CM. Do you ladies check internally or is it obvious by what's in your panties or on tp after you wipe? (TMI--sorry!) =)

I have always been regular, up until about a year ago. I was diagnosed with PCOS in Aug 07 and placed on Met and Prometrium to bring on period. This last month, I got AF on my own, without the prometrium. I have also read and heard from several other people that just because you have AF, doesn't mean that you are O'ing. The only way to officially know is to have b/w done by your doc (I think around cd 21?) and they can tell you. What you can do on your own though, is track your temp, opk's, watch your CM, etc.

bethie3379 · 01-09-2008, 04:10 PM

for what it's worth, I agree with AHoff....you can have what seems like a period, but it is not actually a true period b/c you did not O...when you do O, your period is caused by progesterone withdrawal, if you have an anovulatory cycle, you can have bleeding that is period-like, but is actually from estrogen withdrawal...you can google it and get some more in-depth info...I actually just did that last week b/c I was unsure if I O'd in December....I have had success with using a cbefm, but using opk sticks was always a little fuzzy for me...g/l!

sheepiegirl · 01-09-2008, 04:13 PM

For what it's worth, I used OPKs and they were never positive for me. So, the theory of if you have PCOS then the OPKs will always be positive isn't always true. And Metformin didn't get me to ovulate either. I'm not trying to be difficult, but it's not as cut and dry as peppa said it is.

peppagrl · 01-10-2008, 12:21 AM

sheepiegirl - I think your misunderstanding me. OPKs detect the rise in LH of an ovulatory cycle. So if PCOS is significant for elevated LH, the LH to FSH ratio would be 2:1 or 3:1. If you have PCOS and IRREGULAR cycles and you take the opks for a couple of days you have what is considered a false positive (the test comes out that you are ovulating when you are really not). LH and FSH is low during your period (of a regular cycle) and then the LH starts to rise right before ovulation and that is what an OPKs detect. You want LH to peak and then decrease, not stay elevated througout your cycle.

I think of PCOS as a spectrum. One drug like metformin doesn't work for every woman with PCOS. Some women like Avandia. And, some women like the great alternative Chaste tree (Vitex) for normalizing all their hormones. It's all about preference of which one works.

You are right that there is no clear cut answer to why pregnancy is still harder for women with PCOS and regular cycles, but we have an edge over women without regular cycles. Unfortunately, we still have lower levels of progesterone and so our ovulation time period is still sooo short. Metformin and vitex are some of the drugs known to nudge your progesterone levels up. This is probably why women with PCOS have a hard time getting pregnant. It's the narrow window where we can get pregnant.

Even women who don't have PCOS may not have or show ovulation every month and sometimes that may because of stress (the egg is hiding). But, it doesn't hurt for any woman who has PCOS and regular cycles to try the OPKs. I don't think it's giving any woman false hope. It's giving them the confirmation that they understand their body. What's wrong with that?

I prepare my body for the time of ttc with metformin (will continue after the Lupron) and testing my cycles with the OPKs just to log a pattern. I know it's not going to be easy, but I'm trying.

carriebabbie · 01-10-2008, 09:30 PM

Thought I'd get in the mix on this one. I get a regular cycle but absolutely do not ovulate all the time. I know because I did temp. Beth is right that your period is from estrogen withdrawal instead of progesterone withdrawal like other women get. Also, because some women have high estrogen, which is responsible for fertile cervical mucus, they can have EWCM even when they are not ovulating.

When I got pregnant, I was on metformin and Saw Palmetto, which by the way helped clear up my skin. I don't think it was necessarily the metformin that helped me get pregnant though.

I tried a natural fertility herb that had vitex in it. That's when I discovered that Saw Palmetto cleared up my skin. I was gonna give the herb a try again in another 3 months (still have the meds as a matter of fact.)

I tried OPKs once and also got a negative all the time. That cycle I know I didn't ovulate because my temps were very erratic. Got my period in exactly 28 days on that cycle. If you're going to do them, I would definately reccommend buying a lot of them from online. I think one of the girls gets them through Amazon.com. That way you can test for more than seven days. If you find that you ovulate on cd 20 and get your period 9 days later, that could mean you have a luteal phase defect which definately prevents you from getting pregnant because your progesterone drops too soon.

Have you thought about joining them on the TTC board. Thay are an amazing group of women. Even if you don't have PCOS they can certainly help you through the long process of TTC. They've had quite a few graduates.

Hope to see you on the pregnancy boards very soon.

Carrie

carriebabbie · 01-10-2008, 09:33 PM

Soon to be Dr. Pepper (congratulations, you're so close)

Are you TTC too? I couldn't really tell by reading your bio.

CAheather · 01-11-2008, 04:49 AM

All right, well I think I'm screwed. I get my periods like clockwork every month and usually have the eggwhite cm each month, but I don't think I'm ovulating. This is my first month really watching for it. It should have happened yesterday, in fact, and I could swear I'm having ovulation pain from my right ovary, but a negative on the OPK and nothing spectacular temp-wise or CM-wise.

I guess I'll give it a few days... but if something doesn't happen soon it's looking like I'm either not ovulating or I have a luteal phase defect. I hate this disorder. Truly. To think I spent years trying to be a good girl and being so careful not to have a baby before I found the right man to be the father and it was the "right" time, and now that it is... I just hate this disorder.

carriebabbie · 01-11-2008, 08:11 PM

I've felt that way too. Like had I known, I would have been trying to get knocked up a long time ago. However, I'm glad things turned out this way because I couldn't imagine still having to deal with some of the men I've been with.

Good luck Heather. For what it's worth, my temperature increase when I ovulated didn't normally happen right away unless I was on clomid or pregnant.

Carrie