Expert: Lawrence Jay Rappaport <B>M.D.</B> - 8/4/2005
Question I am 19 years old and my husband and I have been trying to have a baby since we got married Oct. '04. My doctor found out a couple of years ago that I am insulin resistant and so she put me on Glucophage 2000mg a day. I was on that and the Nuva Ring until I decided to get pregnant. I went to my doctor in January after we had been trying on our own. The doctor lowered the amount of Glucophage to 1500mg a day and then put me on Avandia 4mg a day for two weeks and then 8mg a day for two weeks. I didn't have a period the first month,but by the second month I had one on my own. Shortly after that I noticed a rash that began to spread all over my body. My doctor took me off of the Glucophage and left me on the Avandia 8mg a day. I took that for a month and I didn't get my period on my own. The next month I went back on the Glucophage. The doctor also tried having my take Femara during certain cycle days to help me ovulate. Recently I have decided that all of the up and down with my hormones is getting to be a little much. My husband and I were having some problems so the doctor took me off of the Avandia and Metformin and gave me Provera to take for 10 days and at the end I was to start the Nuva Ring again. Well, I took the Provera and finished it about a week ago and I still haven't started my period. During the time I was on the Provera my husband and I had unprotected sex. Could I be pregnant and not realize it? Or will it take longer for the Provera to work properly?
Answer If you did not get your period due to a deficiency of progesterone, Provera 10mg twice a day for 5 days will usually bring on your period within 10 days. Sometimes, a second course of Provera must be taken. However, sometimes, if you do not have a thick enough endometrium, you must first "prime" the endometrium with Estrogen (for 21 days) and then take Provera, which will usually work. If you are pregnant, Provera will not induce a period. HOwever, a pregnancy test will be positive. Provera is not dangerous and we used to use it as a pregnancy test in the past. If you have any doubts, take two blood tests for pregnancy (48 hours apart). A doubling of the results in 48 hours indicates a viable pregnancy. A result less than 5 means that you are not pregnant.
