Finally I have had a chance to meet with the Gynecology specialist(s) that deal with women with POF. It took about 6 months after the referral early this year (which I was told was normal). The clinic itself is bascially a group of doctors that get together on the second wednesday of every month to meet with patients with this particular issue. So I believe I am getting the best help I can for my long term health. That on its own makes me feel a whole lot better.
The particular doctor I met with, Dr.E, was a young lady who is the attending that works with Dr. W (the main gynecologist). I didnt have a chance to meet Dr. W, since she was with another patient at the time. But i didnt feel the need to, as Dr. E seemed to get what I was saying and seemed to have a good idea of what I needed.
We spoke for a bit on my symptoms and my fertility options. I told her I had been on the pill for over 10 years before my BP start to rise and so my family doc told me to stop taking the pill. She also completed a vag exam and then prescribed me some long term treatment. This is the HRT I am supposed to take for the foreseable future (while not doing anything in terms of the fertility side of things ofcourse).
- Estring – a small flexible plastic ring (about the circumference of a golf ball) that contains 2mg of estradiol. This is inserted into the vag and left there for 90 days (!) to provice a slow release of estrogen to the vag area.
- Estradot 100 patch – this is another estrogen replacement that I will change twice a week. This is placed anywhere on my body (but mostly around the butt area so it is more discreet).
- Prometrium 3X100mg capsules on days 1 to 12 of the calendar month. Taken orally at night (so as not to cause too much drowsiness, apparently it makes you sleep really well)
The Prometrium is to counter all the estrogen being pumped into my system and to lower the risk of cancer that estrogen alone can cause.
The other gyno (the one that is supposed to do my hysteroscopy) had suggested estrogen cream, which I asked Dr. E about and she said that we could use that too, but she preferred the patch as it was easier to control the dosage and an easier method of delivery. I agree. So far the patch has not been too bad. I even downloaded an app on my phone to remind me when to take the meds.
The only one I am worried about is the estring. So far it is great. I cant feel it and, although I still think about it everyday, it doesnt physically bother me at all. The one thing it can cause is TSS (toxic shock syndrome). Although very rare, this is a risk. I guess it is just like using a tampon, there is a risk but it is small. I am just terrified that I will start to get TSS symptoms and forget that I have the ring in there. I guess just that fact makes me not forget that it is in there. I even told my husband to watch out if I start to complain about any TSS like symptoms. I guess at time goes on my paranoia will subside.
It has been a couple of weeks since this all started and so far so good. No hot flashes (which had started to return a couple of weeks after the last of the estrace and prometrium that I had for the mock cycles). I also dont feel as dry down there, which is great.
And sex with the ring is actually no different. Neither of us can feel it in there, so that is a good thing! (Dr. E had said that some people do feel it and have to pull it out for sex and then put it back in after but we dont)
In terms of longterm risks Dr. E said that the research has shown that the risks are so low for those of us that need HRT so early in our lives that is is worth it. Infact, the risks of not taking the hormones is much worse than it is to take them. While I have not reviewed any of this research, I do believe her. She is the expert after all. And I feel better taking the hormones than not having them.
One thing Dr. E said was that taking these drugs will not prevent pregnancy. So if there happens to be one lone follicle in there, it may just develop. But the chances in my case are extremely low given my numbers. Fair enough. Nothing I wasnt expecting there. But it nice to know that there is a small chance. Even if it is miniscule. One can always hope! I wish to be one of those one in a million women who get pregnant after being told there was no chance. I wish.
But for now we will go with the majority stats and keep planning for fertility treatments. Moment of truth appointment with Dr. H is coming up next week.