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Missed periods, pregnancy test was negative and having loose stools. Minor fungal infection in groin. Why am I missing periods?

Mar 2013
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Practicing since : 1998
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20 year old female, missed two periods, negative blood test for pregnancy + 4 home tests all taken at least a week after period was due or later. Also, loose stools have persisted for the last two months more on than off. No breast tenderness, or vomiting, although minor nausea is Present on occasion, which is unusual. Overweight at 200 pounds and 5 foot 6. Extreme bloating is also present, not painful but belly is hard to the touch. Glucose testing has been done, no diabetes, no thyroid condition (those tests also done). Has minor fungal infection on skin in groin area. Any ideas? Why am I missing periods?
Posted Wed, 20 Nov 2013 in Women's Health
Answered by Dr. Aarti Abraham 1 hour later
Brief Answer: LOSE WEIGHT - PCOD LIKELY. Detailed Answer: Hello XXXXXXX Thanks for writing to us with your health concern. Well, since pregnancy is conclusively ruled out, I can think of the following possibilities - 1. Obesity itself can cause menstrual irregularities. 2. Some kind of stress, anxiety, travelling, change in climate or sleeping patterns. 3. Polycystic ovarian disease - extremely common in overweight women . It is underlined by basic hormonal imbalance, due to which there are multiple very small follicles ( cysts ) in the ovaries, leading to difficulties in ovulation and irregular menstruation. In my practice, for a patient like you, I would conduct a thorough per vaginum and per speculum examination as well as recommend a pelvic ultrasound scan to detect polycystic ovaries. In addition to the blood tests you mentioned , the following would be necessary - FSH LH Prolactin Glucose tolerance test Fasting serum insulin Serum free testosterone DHEAS. These would be sufficient to establish a diagnosis of polycystic ovarian disease if it exists. The mainstay of treatment would be weight loss - even a 5 % weight loss would regulate cycles. In addition, Metformin is a drug commonly prescribed to help you along. The fungal infection would mostly be caused by rubbing together of the inner surfaces of the thighs due to being overweight. You can use topical antifungal ointments like Candiderm ointment. Try losing weight as it will help in ameliorating such infections. Avoid keeping the area wet or damp, local Neosporin powder will work. Wear non allergic organic undergarments or plain cotton or linen. Avoid rubbing, itching or handling the area. Do not use medicated or perfumed soaps , cleansers, douches, tampons, toilet paper etc. All the best. Please feel free to ask for further clarifications.
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Follow-up: Missed periods, pregnancy test was negative and having loose stools. Minor fungal infection in groin. Why am I missing periods? 4 minutes later
Would you really say I am Obese? I mean, im what, 55 pounds overweight? I get that thats bad, but i have weighed the same for about four years and always been super regular. My doctor said she ruled out PCOS too.
Answered by Dr. Aarti Abraham 11 minutes later
Brief Answer: DETAILED BELOW Detailed Answer: Hi again. Your BMI comes out to be 32.3, and more than 30 is defined as obesity. You need to shed a few pounds for sure. If PCOS has been ruled out , do not worry. Occasionally missing a cycle or two can be attributed to stress , ingestion of some concurrent medications, change in lifestyle factors etc. Also, I hope you have seen your doctor AFTER missing your periods, and not before, as PCOS might develop anytime, as may the hormonal conditions listed ( thyroid, prolactin etc ).
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