We saw the GYN yesterday. Two and a half years ago we were referred to Dr. Warner to see if he could help with her chronic daily migraine. We both really liked him, and felt like he was quite knowledgeable. He is retired from his "regular" GYN practice and now just does hormone replacement therapy using bio-identicals.
He was able to look over Alex's labs and have us tell him what was going on and conclude that she is not ovulating, and explain to us how he knows that is the problem. Like I said, he's a smart guy! She is not making progesterone, or at least not enough to cause ovulation to occur. In turn she has breakthrough bleeding and pain 10 out of every 28 days.
He is starting her on a bio-identical progesterone cream twice daily on days 10 to 24 of her cycle. On day 28 she should then have a normal period caused by progesterone withdrawal. That's what would happen naturally if her body was doing what it's supposed to.