Infertility/Fertility/HRT for POI/POF


Hi there, My periods started at the age of 12 and stopped when I was 17 yrs old when I did a lot exercise and crash dieting. Doc said it was Secondary Amenorrhea. I took different meds like Primolut N. But normal cycle did not return. I am 38 yrs old now and my GYN has put me on an HRT after I was diagnosed with POF. My FSH is high (86).I am now taking Progyluton these days. My question is should I continue to take it even though I feel a lot of discomfort like my breasts are very tender and painful and there is swelling and contraction like feeling in deep inside of my lower legs. Is there any other better medicine I can switch to? and don't you think taking transdermal HRT is better than oral one as oral HRT goes straight to liver. Please help me. I do want to get pregnant but I am not ovulating. Is there anything else I should take to enhance ovulation along with HRT treatment?. I live in Dubai. I would greatly appreciate your input in this matter. thank you

Hello Zaina from Dubai,

If you have premature ovarian failure, you are not producing any estrogen and progesterone because your ovaries are not working.  Therefore, you need to take it in a medication form.  You will probably need to do this for life.

If the current medication is giving you side effects, Progyluton is a hormone replacement medication, then you need to try a different one.  There are many different kinds and finding the correct one for your body is by trial and error (trying each one).

Your only option for getting pregnant is to use donor eggs because your ovaries do not work.  Because the ovaries do not work, fertility medications will be ineffective as they require ovarian function.  Since POF does not affect your uterus, you can still get pregnant using eggs from a donor.  The only other option is a study that is going on at Stanford, where they have successfully identified a protein involved in POF.  By blocking this hormone, they have been able to get the ovaries to stimulate and have had successful pregnancies.  Basically they remove a portion of the ovaries laparoscopically, treat that tissue with the new medication and then transplant the ovarian tissue back in.  They then stimulate the ovaries in a traditional IVF cycle.  You'll have to go to Stanford for this so contact their clinic to see if you are qualified to get into their research protocol.

Good Luck,

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

Monterey, California, U.S.A.

for additional information check out my blog at check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at if you are interested in continuous access to me.


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Edward Joseph Ramirez, MD, FACOG


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.


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.

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

American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

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

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