Hi ladies! I have PCOS and have been taking Metformin for about 6 months now. Amazingly enough, my periods have been recently regulated thanks to metformin and now arrive every 30 days. However, I have been charting my temperatures and have noticed that I unfortunately have a short luteal phase (less than 14 days). I would like to conceive, and I am wondering if anyone can offer any advice on what to do to alleviate this problem? Thank you!
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JH1
19 yrs ago
I think I've read that doctors can prescribe progesterone to lengthen the luteal phase. Have you consulted your ob/gyn about this problem? Don't get too discouraged - I've read that women with luteal phases as short as 12 days go on to conceive.
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Thanks JH1 for your reply and your excellent advice. I haven't yet discussed this issue with my ob/gyn because I am currently on holiday. Just curious - do you know if doctors prescribe prometrium (the more natural form of progesterone) for this problem?
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JJB
19 yrs ago
Pregnancy needs at least 10 days for implantation. The norm is 12-16 days.
Luteal phase lengths of less than 10 days are considered too short for implantation to occur, and may thus indicate a problem with successfully achieving pregnancy. This condition is sometimes referred to as a luteal phase defect. Short luteal phases may be corrected with progesterone treatment.
Insufficient progesterone production and a shortened luteal phase may possibly contribute to PCOS. With regard to PCOS, hormonal imbalance (namely insufficient levels of progesterone) may also contribute to the formation of cysts on your ovaries, or Polycystic Ovary Syndrome. As vitex agnus castus has been shown to support progesterone production, vitex may be suggested as a treatment for menstrual cycle imbalances, luteal phase defect, and possibly PCOS (as normalized progesterone levels and cycle regularity may suppress the development of ovarian cysts associated with estrogen dominance).
Clinical studies now support the fertility-enhancing claims associated with vitex agnus castus - as well as its facility in treating common fertility disorders.
You can try and see a naturopath to be prescribed some herbs. Or you can see an acupuncturists and have chinese herbs, if you do not want to supplement with progesterone suppositories, gel or injections.
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Natural progesterone will also help to sort out your luteal phase.
There is some information on luteal phase deficiency on the Natural Progesterone Support Website - a network for women using (or thinking) of using NP.
http://www.natural-progesterone-support.com/infertility-miscarriage-and-natural-progesterone.php
Most doctors will recommend drugs from pharmaceutical companies as these companies market the drugs to the doctors. Most doctors will be unaware of natural progesterone as pharm companies will not make it (natural product so cannot be patented).
Research shows that transdermal cream rather than oral progesterone is recommended, because some 80% to 90% of the oral dose is lost through the liver. Thus, at least 200 to 400 mg daily is needed orally to achieve a physiologic dose of 15 to 24 mg daily. Such high doses create undesirable metabolites and unnecessarily overload the liver.
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Has anyone tried taking Vitex Agnus Castus? I feel nauseous ALL day on Metformin and have even started to throw up in the middle of the night. It's hard to feel this way and go to work. Is it sold in HK? Any feedback would be much appreciated!
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JH1
18 yrs ago
I've read on some websites dealing with infertility that vitex may not be so good for women with PCOS. It appears that in some women with PCOS, it can delay ovulation for even longer.
When I was initially on metformin, I felt deathly tired and dizzy. It got a little better after a few months, but I have to say I still had low energy a year into it when I stopped taking it. The GI upsets continued till the end pretty much. At one point I also got sores in my mouth, which could have been due to the metformin blocking B12 absorption. (By the way, if you're not doing this already, take a good B-complex vitamins.) It seems to take at least 3-6 months for most women to adjust to metformin/glucophage. I've also read that the extended release form of glucophage is easier on some women.
Babeez, good luck with your appointment with Dr. Ho. If you're still unsure of the diagnosis he makes, you may want to consult yet another doctor who is knowledgeable about PCOS.
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I don't have PCOS but my lutheal phase was VERY short when I fell pregnant a couple of months ago. Until now, the pregnancy goes very well. My luteal phase was 5 days only (!) and I had implantation spotting on day 5 after conception. The pregnancy test showed positive about 10 days after conception. It is possible ladies!
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Thanks again JH1 and smegal.
JH1- I have changed my appointment to see another doc on Friday instead in Shatin. He was also highly recommended but much cheaper. I asked my local GP for advice and she told me she knew this guy personally and that he was a wonderful doc. He has all the equipment at his office and it seems a better option for my husband and i financially as we would like to stick with one doc and as much as we would like to have Dr. Ho, it may prove too expensive for us over a long course of time. If this appointment doesn't go well, then i will try Dr. Ho as my next option. Fingers crossed though! :)
smegal- Congratulations! How long did you try for? It's great to hear some 'miracle' stories.
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We only tried for 3 month and it is indeed a miracle! I have been with Dr. Ho for years and had several operations with him (cysts, cancerous cells etc.) so chances for me to conceive were supposed to be low. He is a very good Dr. and even though expensive the money was well spent!
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anyone know about after laparoscopy surgery with PCOS did you get your period naturally or only by chemical induce ( provera, medroxyprogesterone, or Marvelon with clomid ) again ?
regards
anxious
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Hi JH1,
I saw Dr. Ho today and he was GREAT. Such a different experience. Thank you for your recommendation. I do have PCOS but have no need to be on Metformin as i ovulate by myself. He said to try naturally for 6 months-1 year and see him again if nothing happens. He will do the progesterone test next cycle. Thanks again for helping me find a wonderful doc! Baby dust for us all!
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JH1
18 yrs ago
Hi, Babeez! I'm really happy that you liked Dr. Ho. It's nice that you don't have to be on metformin. May I ask you what your age is and how long you've been trying to conceive? I'm just asking because if you're under any time pressure or if you've already been trying for a while, may be you'd like to start treatment sooner than that?
Also, might I ask what factors he cited for the PCOS diagnosis? As I recall, you didn't exhibit many symptoms? (I had a similar profile as you, but he said I did not have PCOS.) I've been through a few doctors, and I think it's important to come to your own informed decisions about your course of treatment.
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Hey JH1,
I am 29 years old and have just been trying for three months. I know it seems premature to do the check-ups but i just wanted to make sure that everything was ok internally as i had spotting and irregular periods before the pill. That's when the first lady doc told me i had PCOS. She told me there was only 5% chance of me conceiving naturally but then yesterday, Dr. Ho checked and said that because i ovulate, i can try naturally and that the Metformin wasn't really increasing my chances. He gave me the option of stopping or continuing and i've decided to stop as i went to the last final doc today (never seen so many docs in a month!) to get a final opinion and he said that i do have small cysts but he couldn't say whether it was PCOS or not as i didn't seem fit the profile and my hormones looked good. He too told me to try naturally so i have decided to try to stop stressing (TRY!) and just keep checking that i ovulate. What about you? Are you taking a break or still trying now? What treatment are you using?
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JH1
18 yrs ago
Hi, Babeez! Given your age and that you've only recently started trying, it seems quite reasonable to keep trying naturally for a few more months before resorting to more aggressive methods. I hope that things will work out well for you! I've been on a break for a while but will be resuming treatment at Queen Mary this month. I am off metformin.
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I wish I went to see Dr. Ho in the beginning as well for my PCOS/irregular periods. I saw a different doc and wasted a lot of time and money. All I needed was Metformin - it takes 3-6 months for it to start working and regulating your periods. Once my periods were regular (every 30 days) due to the Metformin, I got pregnant asap. Try to give the metformin a chance and see if it works for you....
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Hi JH1, I know it seems silly to worry so early but i guess when i went for the routine check-up regarding spotting, i wasn't prepared to be told that i had 5% of conceiving...still, i am more relaxed now and giving things a try naturally and i will pray for you that things work out well SOON!
myfavoritebags: congratulations to you on your pregnancy! I was just wondering if you stayed on metformin after you conceived?
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JH1
18 yrs ago
Babeez, it seems that the doctor didn't really have a good basis on which to determine you had a 5% chance for conceiving. Good luck to you! Wouldn't it be wonderful if you end up getting pregnant naturally? Thanks for your wishes.
I already had regular cycles before metformin so it's not clear what it did for me during the year I took it. I think it depends on the doctor, but if you have PCOS, doctors often advise that you continue metformin through the first trimester (sometimes for the duration of the whole pregnancy).
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I stayed on metformin for the first trimester, due to doctor's advice. I wouldn't go by that 5% number your doctor told you, that's probably his guess or opinion which could be completely wrong. I know quite a few women with PCOS who were told (like myself) that they would have a really difficult time conceiving, but none of them actually did.
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Well2
18 yrs ago
i used to have 9-10 days LP. After taking vitaminB6 + Vitex. LP went upto 11 days. And i am now 35wks pregnant.
Good luck to you :-)
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Hi, could someone give me Dr Ho's details? I have been on Metformin for 8 months and I still feel awful all the time. I am not trying to get pregnant (I check this forum for PCOS info!) and I ovulate by myself so I have no idea why my doc put me on 3000mg/ day of this horrible drug which is definitely not cheap either. I'd love to get a second opinion from another doc who knows what they're doing.
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JH1
18 yrs ago
Dr. Philip Ho
Well Woman Health Clinic
710 Hing Wai Building
36 Queen's Road Central
Tel: 2899 2293
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hi Chirigui,
May be you should ask your doc for the new meds " Actos" sister chain from Avandia. Less or none side effects at all: but only very few study about this new meds !!
Only need to check your liver function every 1 year for the first 3 yrs of use.
Try la - no harm !!!
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