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ObGyn/Pregnancy issues/Breastfeeding and hormones


Dear Dr Kandeel

I am a 38 year old mother to a 10 month old baby girl conceived after many miscarriages and 5 fresh cycles of IVF. 6 months prior to becoming pregnant I was diagnosed with premature ovarian failure because tests which showed a day 2 FSH of 20 and an AMH of 9.8 (I was 36 at the time).  I was told to continue with IVF and then when I was done (whether successful or not) to return for hormone replacement therapy.

Fortunately the very last cycle and my very last egg succeeded.  I have breastfed consistently since the birth and my little one is not too interested in solid food despite constant encouragement.

I have symptoms of low estrogen and since her birth have not yet been able to have intercourse with my husband because my skin tears immediately and we cannot continue as it hurts too much.  I have been prescribed estrogen pessaries but they haven't helped yet.  Is there anything else I can do or is my husband going to need to wait until I wean my baby.

She is my only child and we aren't likely to have another so I don't want to wean her too quickly.

Any advice will be appreciated.


Your doctor may have placed you on the lowest effective estrogen dose to avoid side effects that may occur especialy if you are overweight, diabetic or smoker. You may discuss with your doctor to increase the estrogen dose mildly just to avoid pain and tears during intercourse. Alternatively, you may try some vaginal lubricants available in the Australian market where you live that may be of help.

Good Luck

ObGyn/Pregnancy issues

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Mohamed Kandeel


I can answer questions about antenatal care, medical problems associated with pregnancy, labor and delivery and postpartum care.


Currently I am working as a Professor of Obstetrics gynecology, Menofyia University, Egypt. Since 1987, I worked in many university and private hospitals with a high load of pregnant population averaging 7-9,000 deliveries/year. This exposed me to all problems associated with pregnancy, labor and delivery. I had my doctorate degree in Obstetrics and Gynecology in 1996 in the use of Doppler ultrasound in high risk pregnancies.

Menofyia University, Egypt

-British Journal of Obstetrics and Gynecology (Kandil M) -Egyptian Journal of Obstetrics and Gynecology (Kandil M) -Ain Shams Journal of Medicine (Kandil M)

-Master's degree in obstetrics and Gynecology 1989 -Doctorate degree in Obstetrics and Gynecology 1996

Awards and Honors
Editorial advisor: Fetal monitoring section of the international website

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