Hi lisa789
So sorry to hear not only about your gynae problems but also that you haven't had a proper consistent diagnosis from the medical profession.
There is clear information about premature menopause/premature ovarian failure - on this website.
Go to the top tab menopause and the sub-tab is premature menopause, and there is a whole list of pages about it - including causes, investigations and treatments. Clearly you were under 40 when you first started having problems. The new NICE Guidelines on menopause also set out the course of events and tests which should take place and they are here:
https://www.nice.org.uk/guidance/ng23/chapter/Recommendations#diagnosing-and-managing-premature-ovarian-insufficiencyI'll reproduce it for you:
Diagnosing premature ovarian insufficiency
1.6.1 Take into account the woman's clinical history (for example, previous medical or surgical treatment) and family history when diagnosing premature ovarian insufficiency.
1.6.2 Diagnose premature ovarian insufficiency in women aged under 40 years based on:
menopausal symptoms, including no or infrequent periods (taking into account whether the woman has a uterus) and
elevated FSH levels on 2 blood samples taken 4–6 weeks apart.
1.6.3 Do not diagnose premature ovarian insufficiency on the basis of a single blood test.
1.6.4 Do not routinely use anti-Müllerian hormone testing to diagnose premature ovarian insufficiency.
1.6.5 If there is doubt about the diagnosis of premature ovarian insufficiency, refer the woman to a specialist with expertise in menopause or reproductive medicine.
Managing premature ovarian insufficiency
1.6.6 Offer sex steroid replacement with a choice of HRT or a combined hormonal contraceptive to women with premature ovarian insufficiency, unless contraindicated (for example, in women with hormone-sensitive cancer).
1.6.7 Explain to women with premature ovarian insufficiency:
the importance of starting hormonal treatment either with HRT or a combined hormonal contraceptive and continuing treatment until at least the age of natural menopause (unless contraindicated)
that the baseline population risk of diseases such as breast cancer and cardiovascular disease increases with age and is very low in women aged under 40
that HRT may have a beneficial effect on blood pressure when compared with a combined oral contraceptive
that both HRT and combined oral contraceptives offer bone protection
that HRT is not a contraceptive.
1.6.8 Give women with premature ovarian insufficiency and contraindications to hormonal treatments advice, including on bone and cardiovascular health, and symptom management.
1.6.9 Consider referring women with premature ovarian insufficiency to healthcare professionals who have the relevant experience to help them manage all aspects of physical and psychosocial health related to their condition.I'm not sure what the position is if FSH varies to that extent - but I presume that the fact that it is raised several times means that the ovaries are failing, but the fact that sometimes the reading is normal means that they are working intermittently? There is greater variablity in hormonal profile for women with POF than normal age menopause.
I think the gynae conusultant means you are heading for POF since you wouldn't have periods if your ovaries had failed although according to the STRAW model of reproductive ageing - some women with crietria of POF (4 months without periods and 2 blood samples with elevated FSH a month apart) - can have spontaneous resumption of periods.
http://www.imsociety.org/downloads/email_downloads/2012_02_16_1773491/straw10.pdf ( Page 6 - Inclusiveness of STRAW10 criteria).
I agree how can you take blood samples on days 2-5 of cycle if you are not bleeding? I think possibly that day criteria for taking blood sample does not apply to POF otherwise you could be waiting for ages!
The most important thing is that you do need to be on HRT asap - notwithstanding the consultant saying wait for 4 weeks. At your age you might find that the contraceptive pill stabilises your hormones levels while at the same time giving you the oestrogen you need to your age. There is a fairly new one called Qlaira which contains estradiol - the same oestrogen as in our bodies - and only has 2 or 3 tablet free days - so ideal to prevent pms. The only thing is that you would need to be able to tolerate the progestogen in that one.
This is a bit of a ramble but hope it contains some helpful information. You definitely need to be under a specialist, and one who is au fait with early/prem menopause as well as HRT!
Good luck and let us know how things progress.
Hurdity x