Patient's question:
Detailed medical condition and consultation purpose: I have been experiencing menstrual cycles only when taking medication since last year. When I stop taking the medication, my periods don't come. Later, I took Mifeprex (estrogen supplement) for three consecutive months, but after stopping the medication, my periods still didn't come. My FSH is 17.41, E2 is 6.15, and LH is 7.03, all tested on the second day of my period. Is this premature ovarian failure? Should I continue taking Western medicine to supplement hormones or opt for traditional Chinese medicine treatment? Thank you!Doctor's answer:
Hello, it is best to use hormone therapy under the guidance of a doctor.Principles of Treatment:
(1) Artificial Cycle: Periodic supplementation of estrogen and progesterone can prevent the atrophy of the epithelial tissues of the reproductive organs and calcium loss, as well as protect the cardiovascular system and prevent changes in lipid metabolism. Estrogen can be started at any time, such as ethinyl estradiol 0.5–1 mg, once daily, for 22 days. Progesterone should be supplemented starting on the 11th day of medication, such as oral medroxyprogesterone acetate (MPA, also known as dydrogesterone), 8–10 mg, once daily, for 10 days. If progesterone injections are used, they should be started on the 16th day of estrogen intake, with a daily intramuscular injection of 10 mg, for 5 consecutive injections. If ethinyl estradiol 5 μg is taken, it should be administered once daily for 20–22 days, followed by progesterone.
(2) Inducing Follicular Development: After a stage of artificial cycle treatment, a low dose of estrogen should be used alone, such as ethinyl estradiol 0.5 mg or 0.25 mg (equivalent to ethinyl estradiol 12.5 μg), once daily, for 3 weeks, followed by a 1-week break. Regardless of whether withdrawal bleeding occurs, the second cycle of treatment should be started. Three cycles constitute one course of treatment. After the estrogen level slightly rises and FSH and LH are suppressed, HMG can be appropriately used to stimulate follicular development, even ovulation.
(3) Immunosuppressants: Cortisol can be used for patients with adrenal cortical insufficiency.
(4) Traditional Chinese Medicine (TCM) Treatment or Combination of TCM and Western Medicine: Commonly used herbs that nourish yin, reduce fire, tonify the kidneys, invigorate blood, and combine with estrogen to gradually restore ovarian function.