What is Going On With Me?

Hi, I have a number of questions, as my menstrual cycle has changed dramatically over the past year, and my husband and I have also been trying to get pregnant during the same period.
I am 32, started my periods at age 11, and had generally regular 26-28 day cycles until around 11-12 months ago. In the past, I would have five days of bleeding or so, bright red, moderate flow, with menstrual cramping the first two days or so, with tender swollen breasts and irritability before starting. I am five foot seven inches, with a slender, though pear shaped build. My weight has fluctuated from around 135-140 (average), with my heaviest time at around 155 about a year ago. I am now at 140, and have been exercising frequently (running and weight training) about five days per week for the past four months. I have suffered from cystic, cyclical acne pretty much since my teen years. I took Accutane around age 20, which worked for a while, but have since had consistent acne (just on my face). I have some dark hair on my upper lip that I wax and pluck occasional dark hairs from my chin, but am not super hairy.

I was on the pill (orthotricyclen and then levlen) from about 2002-2006. I completely lost my libido about the time I went on the pill. It has not come back. I also have suffered pain with intercourse pretty consistently (it is rare that it is not painful). My lubrication with intercourse is quite poor, although recently we have been able to do it sometimes without outside lubricant.

I should probably also mention that I am a high anxiety person. I stress about everything – am a type A personality, high achiever, who likes to take on other people’s problems as well as my own. I was on Paxil from fall 2005-fall 2006 for depression/anxiety. I have trouble turning my brain off when I am stressing about something. I am a lawyer, and find it boring, tedious, and stressful. My husband and I moved to London from the US 18 months ago, and have struggled to make any friends. I try to help my family out with a lot of different things. My sister has schizophrenia (finally diagnosed almost two years ago), and I manage the paperwork and finances associated with her care. I was crying every night about my job as a lawyer here, so my husband urged me to quit. I have not been working for the past five months, and have been trying to get healthier and figure out what else I might want to do. We are due to move back to the US in a year, and are basically counting the days until then.

In the past year, I have noticed the following changes:
– cycle length is completely erratic, ranging from 21 days to 28 days. Most often it varies from 21-24 days.
– no tender or swollen breasts before my period.
– brown spotting (mostly just on toilet paper or if I push the toilet paper into my vagina) about 3-5 days before my period starts.
– much lighter flow, with mostly brown blood, sometimes just brown clumps, rather than the red flow I was used to. I barely need one pad per day, and there is little overnight flow, where there used to be substantial flow.
– much shorter period, sometimes as short as two days, with maybe a day of spotting afterwards.
– severe cramps the first two days of my cycle.
– loose stools prior to and during my period.

I am living in the UK, and working with the fertility doctors here. I had a number of tests run, including:

-HSG – tubes are clear.
-Vaginal Ultrasound – ovaries look healthy, with average number of follicles, and there’s a sub serosal fibroid measuring 2.2cm (viewed as insignificant).
-FSH day 3 was 5 (was told this was normal)
-LH day 3 was 2 (was told this was normal)
-Prolactin- 155 (was told this was normal)
-Progesterone day 19 was 19 (was told that it should be 30+ to indicate ovulation)
-Testosterone 1.3 (was told this was normal)
They also ran a thyroid and an estradiol test, which they said were fine.

My husband’s sperm was also checked, and is healthy in all respects.

I was told that everything looks fine except I am apparently not ovulating. The doctor did not really listen to me about my cycle and bleeding irregularities.

To stimulate ovulation, I have been prescribed Clomid (50 mg) for three cycles. I just took it days two to six of my first cycle, and am scheduled for an ultrasound on day eight. They do not plan to otherwise monitor my cycle (with blood tests or further scans).

I am concerned about getting pregnant, but I guess, most fundamentally, I am concerned with what is going on with my body, and why it is behaving so strangely. We are on socialized medicine here, so it is pretty much impossible for me to request extra tests.

When I research my symptoms, it sounds like I must have some sort of hormonal problem, like PCOS, thyroid issues, hyperprolactimia, or premature ovarian failure. But, my test results don’t seem to line up with that.

Do you have any suggestions for figuring out what is wrong with me, and my best chances of getting pregnant?

Thanks very much for your help!!

Angela