Dear Doctor, My periods disappeared when I was 34, luckily after I had my three children. Now I am 48, in a relationship and my partner wants at least one child. Is there any medication that can trigger the periods again and is it possible to have a child? Jane.
Dear Jane,
Thank God you had already had three children before this happened. Menstrual periods disappearing at 34 years could be an issue of Pre-Mature Ovarian Failure.
For any woman, menstrual periods are expected to cease from above 40 years. This is called menopause. However, menopause can occur in a few women below 40 years, an indication that the ovarian reserves (egg reserves) have been depleted.
A woman is born with all the eggs in the ovaries that she will have in her life time. So each month, from the onset of puberty at around 10-13 years, a woman loses about 3050 eggs from the reserves. Some women are unlucky that the reserves will get depleted prematurely or in a way stop to function due to different causes. When this happens and one still wants to conceive, the goal is to determine egg availability in the ovaries.
The doctor requests for such tests as below: Transvaginal/Trans abdominal scan to examine the uterus and the ovaries. In the ovaries, the interest is in looking at size of the uterus and measuring its inner lining (Endometrium).
In the ovaries, we look out for any activity by counting the antral follicles (egg pockets). Hormonal profi le which include Follicle Stimulating Hormone (FSH), Estrogen and Anti Mullerian Hormone (AMH). FSH and Estrogen help us determine whether values are menopausal or normal ranges. AMH value helps us judge how much could be left in the ovarian reserves.
Basing on results of the tests, a fertility specialist will advise on how to conceive by undergoing through In-vitro Fertilisation (IVF) aka test tube baby treatment.
Answered by Dr Joseph Kafuuma Women’s Hospital International and Fertility Centre, Bukoto-Kampala. Send questions to the Dr via editor@goodnewskla.com
