In anticipation of my upcoming sonohystogram, I scheduled an appointment to get my bits waxed. I've always done this for all my gyn exams, even before I stated seeing Dr Somebody that I Used to Know. Then I read on Overworked Ovaries that Jen S prepared for her appointment by getting a pedicure and I was inspired to do the same. As a consequence of years of sports, I have such horrible toes and I never saw any point to getting a pedicure, since I would quickly ruin the work of the manicurist. Then, I recalled how when I was in school, my mother used to advise me to dress well on the day of a big exam. Her theory was that if you have a positive self image, you'll feel more confident approaching the test. I decided that by covering the embarrassment of my flawed toes, I could feel even better about myself, which could help me as I received the news of my results.
So about my uterus... It's been a pretty peaceful co-habitation for most of my life. My menstrual cycles were rather benign. No cramps that kept me from missing school or sporting events. No heavy bleeding that caused the humiliation of stained clothes. When I started birth control pills during my quest to be deflowered, there wasn't too much change with my happy-go-lucky period. Then during a routine visit, it was discovered that my blood pressure was 150/110, and I was ordered to stop the pill immediately. Not wanting to face the weight gain with Depo Provera, or the reduced efficiency with condoms, I started researching other alternatives and discovered the Mirena IUD. Hypertension would become the best thing to happen to my reproductive life! Not only did I have a method that was more effective and convenient than the pill, but the period that wasn't too bothersome disappeared completely.
After more than ten years of amenorrhea, I was prepared for AF to return with a vengeance when my IUD was removed. I went to Costco and purchased a large multi-pack of tampons. (Seriously, why did it take manufacturers so long to come up with the multi-pack box?). AF announced herself with barely a whisper. I only need 3-4 light tampons on my first day. The second day I can get by with one pantyliner and on days 3 and 4 (if there is one) I'm just noticing a few spots on the TP. Even during my miscarriage, I hardly had any bleeding. I've scoured all my texts books and there is little written regarding the 'pathology' of hypomenorrhea. I can't recall even having a patient complain about a menstrual cycle that is 'too light' and 'too short'. I gave Co-worker all my medium and super tampons and she went through both boxes before I finished the box of light absorbency ones.
My RE thought it was likely a normal variant. As I was ovulating, I wasn't hypothalamic, and I didn't have any risk factors that would contribute to Asherman's syndrome. It was noted that I may have a slight septum during my initial evaluation, and he had agreed to evaluate with a sonohystogram. The saline infused ultrasound confirmed it's presence and estimated 25-30% depth. He noted that it isn't always clear how much a septum of my size contributes to infertility or pregnancy loss, but he recommended moving forward with a hysteroscopic resection. For the record, I had scheduled a sonohystogram in August, wanting to evaluate my uterus while we waiting for Husband's Clomid to take effect. The appointment needed to be rescheduled and I wasn't able to come in during the required time. My RE examined the films from my hystosalpingogram and thought the septum if present, was only slight and likely insignificant and deferred the sonohystogram at that time. But I am digressing... I'm pleased that he was decisive with the decision to go forward with resection, rather than taking a more conservative 'wait and see' approach.
I must admit I am a little surprised. A part of me thought I'd go in and learn that my uterus is normal and I've been over analysing my scant flow. I feel validated that I pursued having this study done, although it now means another procedure and more waiting. Better to wait and do it right with my new and improved uterine cavity.