Hormone treatment in case of a disrupted menstrual cycle

If a couple has an unfulfilled desire to have children and there is a disruption in the female partner’s menstrual cycle, a hormone treatment may increase that couple’s chances of conceiving. A menstrual cycle disorder is a condition involving an irregularity in the menstrual cycle. In most cases, the underlying cause of a disrupted menstrual cycle is a disrupted hormonal balance. If your menstrual cycle is irregular, causing your ovulations to be irregularly timed, too, a hormone treatment may be a useful option for you.

This hormone treatment is also known as ovulation induction, and it’s aimed at stimulating oocyte maturation. This will regulate ovulation and stabilize the menstrual cycle. In this way, the odds of conceiving successfully increase. The success rate for each treatment cycle varies heavily, depending on the woman’s age and the severity of the underlying hormonal problem. On average, it’s between 10 and 20% every month. Therefore, we tend to advise continuing this treatment for a duration of at least several months.

In which cases could a hormone treatment help?

Usually, ovulation should take place every month, 10-14 days before the expected first day of a woman’s period. In some cases, however, ovulation only takes place every now and then, or not at all. Without ovulation taking place there is no way to conceive naturally, since that means that there’s no oocyte ready and waiting to be fertilized.

If someone doesn’t ovulate regularly, her periods will also be irregular. If two of your periods have been 35 days or more apart, and this has occurred several times, you may have a disrupted menstrual cycle. Depending on how severe this irregularity is, you may benefit from a hormone treatment. This treatment will increase your chances of conceiving naturally by regulating ovulation.

Diagnostics

Prior to starting a hormone treatment, your treating physician will conduct an extensive examination. During it, they’ll take a look at whether your hormone balance is disrupted and if it is, which hormone levels may be too high or too low. In addition to this, your physician will monitor follicle growth using ultrasound examinations, and see whether you ovulate or not. This information is necessary to determine whether hormone treatment is necessary and which medications may be best suited to your treatment.

What’s the process of a hormone treatment?

If you are over- or underweight, changing that (with the help of a nutrition specialist if necessary) has proven useful in many cases. Many women find that their menstrual cycle will regulate itself naturally after they’ve reached a healthy weight.

If you’re at a healthy weight but you still have a disrupted menstrual cycle, starting a hormone treatment may definitely be of aid. The medical term for treating a disrupted menstrual cycle is ovulation induction. Several types of medication can be used to induce ovulation. The preference order of these depends on the cause of the menstrual cycle disruption.

Inducing ovulation using pills

This treatment is made up of the use of Clomifeen (Clomid) pills. The treatment usually starts between the third and fifth day after your first day of menstruating. Clomid induces the production of the hormone FSH, which stimulates the ovaries to start the maturation process of a follicle. The goal of this treatment is to make sure ovulation takes place earlier in your menstrual cycle, shortening the cycle to less than 35 days. Sometimes the medication doesn’t take effect immediately, and we’ll increase the dosage.

If this type of medication improves the regularity of your menstrual cycle, we’ll treat you with it for a duration of between six and twelve cycles.

Inducing ovulation using injections

If a hormone treatment using pills doesn’t provide the desired results, another option is to initiate a treatment using FSH injections. These, too, will stimulate the ovaries to start the maturation process of a follicle. When a follicle has matured enough, ovulation will take place. During this treatment, you’ll inject yourself with FSH every day for several days. It’s easy to learn how to administer this treatment. The growth of the follicles will be monitored using ultrasound examinations, which will take place at several points during this treatment.

In case of a certain incredibly rare hormonal disorder, a treatment using a subcutaneous hormone pump will offer the highest chance of success.

Ovulation and fertilization

During a hormone treatment, your treating physician will monitor follicle growth using ultrasound examinations, starting at roughly the tenth day of your menstrual cycle. In some cases, ovulation will take place spontaneously as soon as the largest follicle is 18-25 mm in size. In other cases, ovulation needs to be induced artificially. We do this using another hormone: human chorionic gonadotropin (hCG). In this case, your treating physician will explain on which days to have sexual intercourse in order to maximize the chances of fertilization. However, if your partner has a low sperm count, or the sperm cells’ agility is severely decreased, you may need to consider an artificial insemination procedure instead.

Side effects and risks

Any treatment influencing your hormone levels is associated with a number of side effects and risks, which your treating physician will explain to you in further detail prior to starting the treatment. Also, your physician will regularly check oocyte maturation and your hormone levels while you’re undergoing this treatment in order to prevent overdosing and minimize the risk.

Possible side effects of this treatment include:

Hot flushes
Night sweats
Headaches
Exhaustion
Mood swings
Overstimulation: if this treatment caused the full maturation of too many follicles, your treating physician will advise against having sexual intercourse. The presence of a high number of mature oocytes increases the risk of a multiple pregnancy (twins, triplets, et cetera) and that, in turn, may present an increased danger to the mother. The dosage of your medication can be lowered for the next treatment cycle.

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