Infertility/Fertility/PROVERA

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Question
Hey should I take provera? I am borderline PCOS. Any suggestions on how to kick start my periods naturally without meds?

THANKS

Answer
Hello CG from the U.S. (Pennsylvania),

PCOD is an ovarian dysfunction whereby the ovary does not process the ovulatory hormones correctly, leading to increased testosterone and decreased estrogen, and ovulation does not occur.  Because there is no ovulation, the period does not occur, hence no regular cycles.

The purpose of Provera is simple to cause the uterus to bleed and shed whatever lining has been formed leading to a perceived period.  It does not correct the PCO problem.  The other way that we do this is using the birth control pill.

There are currently no cures for PCO.  It is managed according to your goals.  If you don't want to get pregnant, then we recommend using birth control pills to suppress the ovary, suppress the formation of the male hormone, give you adequate estrogen and give you regular cycles.  If you want to get pregnant, then we need to use fertility drugs (actually ovulation inducing drugs) to get the ovary to ovulate and give off an egg.  This is a fertility treatment.

There is not way to "kick start your periods naturally", although I know that people have tried acupuncture, herbal medications and over the counter progesterone.  If any of these really worked, they would be the standard treatment for PCOD.  Alas, they don't work.  In some cases if the patient is overweight, reduction of weight by diet, exercise or surgery so that it gets closer to the ideal body weight will lead to the ovaries functioning correctly.  In some patients, it is weight that causes the ovaries to dysfunction.  In some patients, decreasing insulin using insulin blocking medications such as Metformin, will cause the ovary to work if there is insulin resistance.  This only works in 30% of PCO patients.

I have written extensively about PCOD on my blog if you want more information regarding this disorder and treatments.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  I now provide personalized fee for service consultations/advice/direction via email and payable via Pay Pal.  If interested, contact me via my email at info@montereybayivf.com.  This service will allow you to have your own personal on-demand infertility expert

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Edward 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 19 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, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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