instruction: hi I had my i'd irena removed months ago as I am planning to start trying to conceive soon I am no prior pregnancies and otherwise healthy I have been taking an oral contraceptive pill since the i'd removal as I did not want to become pregnant immediately but I am concerned now that both periods I have had while on the pill since the i'd removal have been extremely light both have only lasted one day and only needed tampons total my periods were typical prior to the i'd and stopped completely while the i'd was in for years before that I was on an ocp so periods were regular but I have been using hormonal contraception since I was a teenager so I am not sure if my physiologic periods would be regular or not I am a pediatrician so please feel free to use medical language I am concerned that these very light periods indicate abnormal endometrial function or some other abnormality that may affect my fertility and I would be very grateful for any insight you have thanks raisin
output: hello doc welcome to icliniq I will explain you a little bit how estrogen progestin contraceptive and a levonogestrel did effect fertility combination of cos suppress basal fish and oh they diminish the ability of pituitary gland to synthesize gonadotropins when it is stimulated by hypothalamic gnrh ovarian follicles do not mature little estradiol is produced and there is no midcycle oh surge ovulation does not occur corpus luteum does not form and progesterone is not produced this means that interferes and block negative and positive feedback of who axis also the i'd mirena which contains levonogestrel reduced the fish there is less follicular activity less estradiol production and no oh surge also cause an local inflammatory section inside the uterine cavity the blockage of who is reversible as far as you interrupt the cop pills the estrogen and progesterone levels will fall may be it will take a few months so who axis will start to functionate normally and the cycle will be ovulatory again so the change of the quantity of bleeding is not so important if your cycle are ovulatory only if you have amenorrhea more than months after discontinuation of cos pills shoud undergo evaluation so it normal to experience change of menstrual cycle after i'd I hope I ve been helpful kinds regards