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Having irregular period. On birth control pill. Started getting blurred vision. Hormone related problem?

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My 23 year old daughter has vaginal bleeding about 33 out of 52 weeks a year. She has been seen by an Ob/Gyn doctor. The doctor has run blood work which came back normal. She has been on birth control to help but still has break thru bleeding. My daughter is very concerned about her vision. She has stated that it has changed. She went to the eye doctor and did need a stronger prescription. She stated that her eyes get blurry. Can all of these symptoms still be hormone related even if her labs were normal? What should she do? I'm not sure where to take her for a second opinion? I would take her to a different town even for a specialist that might be able to help. She is married and will want children someday but not at this time. Thanks for any help you may have. XXXXXXX
Posted Tue, 2 Apr 2013 in Menstruation and Miscarriage
Answered by Dr. Timothy Raichle 1 hour later
Hello, I would be happy to help you with your question.

So she has irregular cycles and visual changes. It sounds like she had a workup, but just to be sure, lets review what should have been checked:

1. An exam including a pelvic exam
2. An ultrasound of the uterus
3. Possibly an additional ultrasound that includes pushing fluid into the cavity which aids in visualization of polyps (called a sonohysterogram)
4. Labs that should include: Thyroid tests, prolactin, and diabetes
5. Possibly an MRI of her head (see below)

Elevation in prolactin can cause irregular cycles, and CAN be caused by a tumor in the pituitary gland (very close to where the optic nerve passes, related to vision). While this has probably been checked, it seems to me that there might be a connection between the visual changes and the irregular cycles. The labs probably should be repeated, and you should seek a second opinion. This second opinion could simply be with another OB/GYN.

I hope that this helps. Please let me know if you have additional questions.
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