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History of lazy ovaries. Periods stopped and have swollen abdomen. Should I consult a doctor?

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Hi, I am 39 years old. I suffered from secondary amenorreah when I was 21 years old for 6 years and was diagnosed with "lazy ovaries". Advised HRT at 26. I was not happy with that diagnosis and consulted a Chinese dr. Treated with herbs and acupuncture and periods returned to normal. I have 2 children - first one at 28 second one at 35, breast fed both for 2 years and periods returned to normal after both pregnancies. My periods have stopped again, I have a swollen abdomen with a feeling of pressure and some pain in my back. I have always suffered with acne and just recently noticed it is getting worse more cyst like spots occurring. I have been suffering with anxiety feelings, shake, sweaty, palpitations, dizziness. Should I seek medical help immediately or give it a few months to see if my periods return to normal. Approximately 2 years ago I had tests and all hormone levels came back healthy - consultant said I was years away from menopause. This was because of complications I'd had from the coil.

Please reply to YYYY@YYYY
Posted Mon, 17 Dec 2012 in Women's Health
Answered by Dr. Timothy Raichle 4 hours later
Hello, I would be happy to help you today.

Can you tell me more about the prior workup?
What labs were done?
Was an ultrasound of your uterus and ovaries ever done?
How long ago, exactly, were the labs done?

Please let me know and I would be happy to help you with your question!
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Follow-up: History of lazy ovaries. Periods stopped and have swollen abdomen. Should I consult a doctor? 22 minutes later

2 years ago I had some intermittent bleeding whilst the coil was fitted. I saw a consultant who checked all my hormone levels and said it was normal and I remember her being quite enthusiastic about the levels as I had been worried about an early menopause because my Nan and had gone through hers at 36, my mother at 45. I was also worried because of my history of missed periods in my early twenties when I had low bone density test that if was starting the menopause then this would have to be a consideration. We decided to remove the coil and everything returned to normal.

Prior to my children approximately 15 years ago (during the secondary ameonrreah epidsode)I had ultrasound on uterus and ovaries and some small normal cysts showed nothing more. I remember having all the hormone levels tested and I was not ovulating. I came away from conventional medicine as I instinctively did not like their diagnosis which seemed inconclusive. My Chinese Dr. treated me by taking my temperature (taken first thing in the morning) to assess my hormone levels and I watched my non varying monthly temperature change throughout my year of treatment until eventually my monthly temperature line varied and my periods returned.

This is the first time I have had concerns about my periods for 13 years and it is the fact that I have not gone longer than 34 days and am now at 40 days feeling bloated etc and all the symptoms that I have mentioned above that I am concerned.
Answered by Dr. Timothy Raichle 5 hours later
Thank you for the additional clarification.

Based on the period of time between ages 20-26, and the description of the non-varying temperatures, what was happening then was an absence of ovulation. Other terms for it are "anovulatory cycles", or "dysfunctional uterine bleeding". While the reasons why you were not cycling in your 20's might be different than now, what is actually happening (the absence or irregularity in when you ovulate) are probably the same.

The other symptoms (worsening acne, bloating, etc.) are also consistent with this observed change in your cycle - it is related to the abnormality in your cycles and the absence of ovulation. Most women start changes such as you are experiencing (absent or irregular cycles) beginning in their late 30's or early 40's. This is not necessarily abnormal. Also, your family history of earlier menopause is also significant and could be playing a role at some point soon.

In answer to your question, your options are as follows:
1. Do nothing and wait for a period - if it does not come, then talk to your doctor about ways to "induce" a period - such as a short course of progesterone.
2. Consider a low-dose birth control pill to regulate your cycles
3. Consider having your doctor re-draw labs related to your thyroid, prolactin levels, and labs related to a condition called PCOS (polycystic ovarian syndrome)

What you are describing is common and probably of low concern at this point. I always remind patients to think about the possibility of pregnancy if they are at risk.

Please let me know if you have any additional questions. Thank you!!
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