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Hi Doctor, A Normally Healthy And Correct Weight 24 Year

Posted on Sat, 25 Feb 2023

Question: Hi Doctor,
A normally healthy and correct weight 24 year old woman has missed 3 periods and has tested negative twice for pregnancy using a pharmacy test kit. She is not showing obvious signs of pregnancy.
She started having weak irregular periods in July ago (3 days late in July, weak in September, very weak in October, weak in November and December) - then stopped.
Coincidently the periods stopped after a meet up with male partner (me) for a week in May 2022 following a 3 year long distance relationship, it was the first physical meeting. He (me 51 years old), had a vasectomy 4 months earlier in January and tested clear at 2 months for sperm.
We spent a week together again in December.
She has mentioned to me that at about 15 years old she had to go to hospital because of periods that persisted for about one year. they treated her with contraceptive pill which helped return to regularity.

Could the absence of periods be related to hormones, pregnancy or the long periods in youth ?

thank you in advance for any advice.

Answered by Dr. Richa Agarwal (3 hours later)

Brief Answer:
It could be due to hormonal imbalance

Detailed Answer:
Hi,
Thanks for trusting us about your health care.
I have gone through your history and understand your concerns.
Menstrual irregularities in her case, could be due to hormonal imbalance cause by PCOS( polycystic ovarian syndrome).
PCOS is a endocrinal disorder in which hormonal imbalance will be there due to cyst in ovary ,facial hair growth and weight gain maybe there
As it is a lifestyle disease ,she has to change her lifestyle, eat high protein diet with lots of vegetables and fruits and exercise regularly.
Get her hemoglobin,HbA1c and TSH level and pelvic ultrasound to see hormonal imbalance.
No need to worry about it and take progesterone for withdrawal bleeding.
It is not because of pregnancy.
Hope found useful, feel free to ask more information.
Good luck
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Richa Agarwal (25 minutes later)

Thank you Doctor

She lives in a very remote part of the Philippines with very little access to clinics (which is why I used this service for advice).

In the first instance we will try to address any lifestyle improvements and diet - even though these have not really changed recently except when she spent time with me - she would have had a better diet for those few weeks.

Exercise is also dontwe will work on

With these done how long should we wait until seeking medication from a doctor- they are half a days travel and then it’s a hospital not clinic

Answered by Dr. Richa Agarwal (41 minutes later)

Brief Answer:
You can wait for one month

Detailed Answer:
Hi,
Thanks for your reply and I fully understand your concerns.
But lifestyle changes are better option and it will take time but effective way and having no side effects.
You can give her one syp.also for induction of menses.
Hope found useful
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Richa Agarwal (40 hours later)

Please explain what is “one syp” to bring on the menstruation as I am not familiar with the “syp”

Answered by Dr. Richa Agarwal (2 hours later)

Brief Answer:
Explain below

Detailed Answer:
Hi,
Thanks for asking again.
Sorry my mistake, it is not one syp.,it is one Ayurvedic syrup which I prescribed in menstrual irregularities.
Hope found useful
Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar