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Studies have shown that approximately the same percentage of women have menstrual cycle abnormalities going on and coming off of the pill but they aren't necessarily the same women.
The slow return of your cycle may be a new hormonal problem that needs an evaluation or just jump starting. You can either be patient for a month or two more to see if it will start on its own or go in to get checked out. There are a number of possible issues from the common (androgen/estrogen imbalance) to the rare (ovarian failure) with a host of other possibilities including thyroid dysfunction. It may be worth making an appointment with your gynecologist to help get your cycles back on track...
I wouldn't beat yourself up over the choice to stay on birth control pills. If anything, birth control pills may be fertility preserving because the decrease in menstrual flow each month probably lowers the chances that you will develop endometriosis.
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If you are not pregnant, it may be very worthwhile for you to see a gynecologist for an evaluation. Ovulation problems are common. As much as 5-10% of women have a problem with ovulation those problems can have adverse effects on your general health as well as your fertility.
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If the FSH was high, that might reflect a decrease in your available egg supply this month. When the ovaries don't respond right away, the brain responds by making more FSH than usual. Hopefully, that was a transient rise that will go back down. When a woman is in menopause (i.e. no eggs in the recruitable pool) then the FSH levels get very high. If you haven't checked, it may be good to measure your AMH level and to do an antral follicle count.
If you are on estrogen therapy, then it can be hard to interpret the cervical mucous signs because one of the effects of estrogen is to increase cervical mucous. Interestingly, no one can look tell if a molecule is an estrogen by looking at its structure. We define estrogens as medications/molecules that have estrogenic effects, i.e. they thicken the lining of the uterus, increase cervical mucous, etc. You may not know if the changes are due to your own bodies estrogen or the estrogen that you are taking. It is good that you are in the hands of an RE to help you figure some of this out. I can get complicated and they have a lot more information than you are able to share with me. Sorry I couldn't be more help. Good luck!
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Vaginal bleeding by itself is a sign that can result from many different conditions so you need to do a little more investigation. A late menstrual period can be a sign of a problem with ovulation, a miscarriage, an ectopic pregnancy, a normal pregnancy, etc. A pregnancy test is a great place to help you begin to narrow down the possibilities. If you are going to be overseas for very long, it may be worth your while to establish a relationship with an ob/gyn so that you have someone local to reach out to if you have a problem. Good luck!
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You are very insightful. Before we had pregnancy tests that detected the hormone hCG, doctors would give women progesterone and if they didn't have a menstrual period it was a sign that they might be pregnant. So checking a pregnancy test is a good starting place.
If you are not pregnant, don't worry that happens some time. If you are trying to get pregnant and have to take the progestin every month then you probably still have a hormone imbalance that is preventing ovulation. Your doctor can do some tests to make sure that you have a correct diagnosis and then most likely he/she will prescribe something like letrozole, tamoxifen, clomid or another medication to help you start cycling (ovulating) on your own. Good luck!
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