Question: Dear Sir,

I am a 35yrs old married women. I have been on 'Dronis 20' for last 3yrs as I was diagnosed with Polycystic Ovarian Symptoms. For last three months I have been noticing of no withdrawal bleeding. I must confirm that I am not pregnant,as I've checked already.

Apart from 'Dronis 20', I take 'Thyronorm' for my Hypothyroidism ,which I have been suffering for 10 yrs and it keeps always under control.

You might ask any sudden change or alteration of my regular life,like stress,new medication etc. No,there is no such.

I also just checked my Routine Blood,Fasting Sugar,Thyroid Profile last week and all reports are normal. I have uploaded the reports.You may check,if you wish.

I take Dronis20 for 24days,then a pause for 4 days,then starts a new pack again. Usually my withdrawal bleeding starts on day 2 of new medication of Dronis and lasts for 1 1/2 days. For last three months during that particular 1 1/2 days I have been facing headache with an overall physical discomfort and also excessive hair loss.Also there was even no spotting.

I must tell you that the previous symptom of my PCOS was excessive hair-loss .I did a complete consultation with the Dermatologist,Endocrinologist and they confirmed the only cause of my hairloss was due to excess DHT that causes from PCOS. After taking Dronis 20,hair fall ceased noticeably.

So,please tell me what could be the cause of the absence of withdrawal bleeding?I am concerned. Also how long should I be on birth-control pill?
Thanks and regards.

Hello Sir,

Thanks very much for responding so soon.

Regarding your query about conception , I want you to know that I never tried to conceive and I will never try to conceive. There is no physical/medical difficulties behind such decision.I am an overall healthy woman. It's just my choice.I know it sounds off beat,but then everybody is different.

When I met my local Gynaecologist 3 yrs. ago, I let him know of my decision of never having an issue, cleary . So in short I never went through any fertility-treatment.

As I said before ,Dronis20 was prescribed to me to combat the PCOS and its related androgenic-alopecia,that I was suffering from.

You mentioned metformin and inositol....no,I never used them.

As a cautious PCOS- woman,I always monitor my weight and diet. I am 5ft woman who weighs 50 kg.No sudden weight loss or gain.

My last Ultrasound scan was performed on 12/12/2014 to check the conditions of my cysts. I have uploaded the report now. You can check. It showed an apparently stable state of my ovaries,since PCOS is not curable otherwise.

So,Doctor I am not planning to conceive.I am not pregnant either. Didn't take any extra medication.I am not obese.I don't have any habit of smoking/drinking.But still no withdrawal bleeding.

I know ,some women on OCP,never have any withdrawal-bleeding at all . But I was having it regularly. Then sudden stoppage for 3 months must have some reason,that I believe.

Do you think I need a dose-escalation of Dronis or it's time I might need a different way of treatment for my PCOS? Or it's peri-menopausal symptoms? I am 35.

Please,help.

Thanks and regards.

Dear Doctor,
As you have asked me that if I wasn't planning for fertility why I was bothered even?
Well,I understand that a regular withdrawal-bleeding means the pills are working the right way and my body is responding properly and also my over all hormone-balance is good.

Doesn't it indicate that something is wrong within my body when there is no withdrawal bleeding? And also as I am aging everyday,I should keep an eye always on my hormones.

However,your suggestion towards the mentioned hormonal-tests/Transvaginal USG were very meaningful. Your guidance would definitely help me to find the cause behind the stoppage.

Thanks again for your time and thoughtful insight.

Regards.

Dear Doctor,

I have arranged all the blood tests,you instructed me to do.Tomorrow at early morning my blood sample will be collected. My only query is,should I take my normal dose of Dronis 20 , today night or should I skip it?

Thanks and regards.

Dear Doctor,

Last week you suggested me to stop Dronis20 for 10/20 days and to wait for withdrawal bleeding.You also mentioned,if even after waiting a period for 10/20 days, wouldn't brought the period,then I would go for the hormones- test.

The updates are........I stopped Dronis and on the 5th day of ceasation,my period happened.It was normal,as previously used to happen. Usual flow with usual amount.So my period came after 3months.

Now,please, tell me what should I do? Should I resume Dronis20?Should I go for the tests? Or will you suggest for a dose escalation?

Regards.

Dear Doctor,
Thank you for your reply.By saying 'general evaluation', what you mean?Please,explain it.
Regards.