Hypothalamic Amenorrhea

[IGHA]

Hello -

I have been diagnosed with Functional Hypothalamic Amenorrhea, secondary to both psychological (I was sexually abused for 2 years as a child) and negative energy balance factors (I exercised hard and ate lightly for ~5 years, BMI ranging from 17.5 to 21).

The condition started when I was in my teens. I was put on birth control pills at age 16, and have basically stayed on them (with a couple of breaks to try the progesterone challenge (triggered a bleed twice, failed to trigger a bleed once) and to try to cycle on my own (I had one spontaneous period during a 1 yr break from BCP during 2003-2004 - then restarted the BCP).

I met with an endocrinologist in 2008 (following a 6-month trial off BCP with no period) who gave me the official functional hypothalamic amenorrhea diagnosis. He put me on the BCP and indicated that a GnRH pump would work well for me to get my cycles going. Unfortunately, my health care provider does not offer the GnPH pump.

I decided to try another route. I started doing traditional Chinese medicine herb and acupuncture therapy in January 2010. I am currently off the BCP but I have not had a period in 8 months. I am maintaining a BMI of 21 and no longer limit my food intake. My exercise is moderate.

I have been in counseling/therapy for the past 6 months, which is also helping - I am sure my psychological health affects my reproductive health.

My husband and I also did an initial consult with a fertility doctor in Nov/Dec 2011, who indicated that I would need to do FSH/LH injectables to get pregnant. I have not pursued this yet, as my husband needed a varicocele repair surgery (done Feb 2012). He has not yet had repeat sperm analysis.

I recently visited an OB/GYN who told me to go back on BCP to "prime the uterus" until we want to do FSH/LH treatment. I am very averse to taking BCP again because of nausea, constipation, mood swings - I also feel that it masks the true root problem which we are trying to repair using Chinese medicine.

All this being said, I am searching for a second opinion and I am hoping to find a practitioner that can offer the GnRH pump. I would like to try to cycle normally on my own if possible to conceive more naturally if possible...I am not sure if you can tell me over this forum if Reproductive Partners offers the GnRH pump, but if you can, please inform me.

My husband and I will need to change our insurance in order to use any private fertility clinic, so if we do come to Reproductive Partners it would not be until late this year or early next year...

Thank you for you help.

[Dr. Wisot]

Hi:

Unfortunately, the last time I checked the GnRh pump was not available as it was withdrawn from the market because there was such low usage. We used to use it and it worked well.

We would be happy to see you when you get your insurance straightened out for the only treatment that I know is available, the combination FSH/LH medication.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group, Inc.
Redondo Beach, California

[IGHA]

Thank you for the information. Have a good evening.