AboutEdward Joseph Ramirez, MD, FACOG Expertise I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.
Experience I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 15 years.
Organizations American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society
Publications American Journal of Obstetrics and Gynecology
Education/Credentials Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco
I just turned 44 (today!). My periods were pretty regular up until 16 months ago when they suddenly stopped. I've had one period in 16 months, and have had my FSH levels tested twice in the past twelve months. The first time they tested, it was 112. The second time, it had dropped to 86. Estrogen levels were "normal," but they didn't give me a figure. Both doctors who have tested me said that I'm in full menopause, though I've had no other symptoms other than the missed periods.
I've recently started seriously dating someone. He's been tested for all STDs (and is fine, as am I), and we had unprotected sex yesterday. And suddenly, this morning, my period seems to have started!
I assumed because of the FSH levels and the missed periods that I cannot get pregnant, but was hoping to confirm this--is it possible to get pregnant given the FSH levels and missed periods?
Thanks in advance for any help you can provide!
~beth (in Baltimore)
Answer Hello Beth from the U.S.,
Happy Birthday! Based on the FSH levels, you are in menopause, and by the way, congratulations on the new relationship. I can't explain the bleeding but that is definitely abnormal. I doubt that it is due to pregnancy, but cannot be sure without any further testing. I recommend that you get checked. In addition, considering how young you are to be in menopause, you might want to consider starting on some form of hormone replacement therapy. The lack of estrogen production will be detrimental to your body in many ways, including vaginal lubrication. Despite all the negative press releases about hormone replacement, recent studies are showing benefit if the woman starts at the time or near the time of menopause. That is why I recommend it. I use a low-dose birth control pill in my young woman because the menopausal formulations are not made for the estrogen requirements of the younger woman's higher metabolism. That should take care of any more abnormal bleeding episodes and make your cycles regular again. More than likely, the bleeding was a last hurrah from your uterus. We call it dysfunctional bleeding, but it still needs an evaluation.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
