Tuesday, January 22, 2008

The end.

It's time for me to stop posting here. I have officially kicked hypothalamic amenorrhea's butt. Whupped her to the curb. So I feel like without that, there's really not much to post here anymore. I will continue to post over at my other blog, http://phred-fwed-schweffel.blogspot.com, so if you're interested in following our story, come visit over there.

I will still post HA related things here from time to time, as I come across them in my reading/research. But that will be it. I'm also going to migrate some of the older non-HA related posts over to the other blog as well.

Thank you very very much for all the support, advice, and free shoulders you've provided me over the years! You guys are the best!

Thursday, January 17, 2008

Hypothalamic Amenorrhea Cure???

I started this blog over two years ago, hoping to connect with other women with hypothalamic amenorrhea, hoping to get advice when I was going through treatment, and subsequently, to help those who are struggling today.

I have not been keeping up on the research of late. But, when I was looking for information for a woman I met through the hypothalamic amenorrhea bulletin board at fertilethoughts about whether there was any advantage to using Femara (letrozole) over Clomid, I came across an abstract that I think is quite groundbreaking.

The article, “New protocol of clomiphene citrate treatment in women with hypothalamic amenorrhea”, offers the hope of using Clomid not just for ovulation induction, but to actually restore normal menstrual cycles! I actually purchased the article so I could read the details of the study they performed, to see if I agreed with the conclusions they drew in their abstract, and also whether Clomid was the only treatment used, or if there was concomitant decrease in exercise or increase in weight.

The only drawback of the study was its size – only eight women were treated. However, all eight resumed cycling, and were still cycling six months later! I think that this treatment regimen is incredibly promising for those still struggling.

The study consisted of eight women, five of whom had hypothalamic amenorrhea from excessive exercise, the other three from restrictive eating patterns. (Aside – HA does seem to be due to an energy imbalance – either overexercising, undereating, or a combination of the two. I have been in contact with 25+ other women with HA, almost all of whom (including me) fit this profile). The BMIs of the women in the study were 17.6 to 19.5 – underweight or very low normal weight. Hormone levels were meauserd at the beginning of the study, and were classic HA – low side of normal for e2 (18-25), FSH (2.9+/-0.4), LH(2.3+/-0.3) and progesterone (0.18+/-.2). The age profile is younger than most of us who are TTC – 17-22.

The treatment regimen was 50mg of clomid for five days, followed by five days at 100mg. Ovulation was then assessed by u/s and progesterone mid-luteal phase (with a fairly stringent requirement of >25nmol). Of the eight patients, six of them ovulated and got their period after just one cycle! They subsequently took 100 mg Clomid CD3-7 on the next two cycles. The two women who did not ovulate after the first cycle repeated the initial regiment, and both did ovulate after that.

After the three months on Clomid, all eight women resumed cycling on their own, with no additional medication!!! In addition, there was no change in eating or exercising habits – the deficit in energy caused by overexercising and / or undereating seems to be very strongly correlated with hypothalamic amenorrhea.

For anyone trying to conceive, I would NOT recommend not changing the eating/exercise habits that led to HA – I think it is extremely important that during pregnancy one is not operating at an energy deficit. You would never starve your child after he was born; it is no different to starve them inside the womb. However, I think that particularly for people whose insurance does not cover injectibles, this new regimen is well worth trying.

Three of the women on the fertilethoughts HA board have now tried this regimen, with similar success (although one ovulated on the first cycle and repeated the 10 day regimen with no ovulation the second cycle). Two others have tried a longer clomid protocol than the standard five days, although not quite this regimen, one successful and one not. It seems that it is well worth giving this new regimen a shot before pursuing more aggressive treatment like injectibles. And so far one BFP!

In short, the protocol was as follows:
Bleed induced through bcp (not necessary; two of the women on the FT board did not get a bleed first)
50 mg Clomid CD 3 - 7
100 mg Clomid CD 8 - 12
u/s to check for follicles

I hope that other people in the HA boat find this protocol, and start pushing it with their RE's. The traditional thought is that Clomid does *not* work for women with HA because of the low baseline estrogen levels. But this seems to be different!

Friday, January 11, 2008

non-pregnant? not exactly!

I was feeling very non-pregnant this 2ww. No cramping 6-8dpo, no sore legs during hockey, no strange temperature feelings showering... basically none of the things that clued me in that something might be going on when I was pg with Ant, or last cycle with my chem pg. I was holding out until 14dpo to test after the debacle that was my last cycle as well. I was 95% convinced until yesterday (13dpo) that it would be negative.

Yesterday my temp was up 0.2 in the am, after what I thought at the time could have been an implantation dip on Monday although hard to tell. That was my first inkling. Then, I started having minor cramping throughout the day. I almost wished I had tested so that I wouldn't have my hopes raised only to be dashed today when I did test.

But they weren't. Dashed that is. I got a lovely perfect positive, with the test line in fact darker than the control line. Holy shit, sherlock!

I thought the best way to let M know would be to leave the test out on the counter in the bathroom (on top of the box, so it was obvious what it was). He is such a man - he was in there alone for five minutes before I joined him, when he asked, "So, did you test"

Friday, January 04, 2008


I've been thinking about moving my posts about Ant to another blog for a while, and have finally put that plan into action. I'll keep talking about HA / TTC stuff here, and post about Ant at my new blog, http://phred-fwed-schweffel.blogspot.com. You can read all about the origins of the name over there, if you care to. I still just don't feel 100% comfortable posting about him and his antics here - I feel much better about it in a totally new place.