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Missing periods. Hemorrhagic cyst found on transvaginal ultrasound. Pregnancy test negative. Worrisone

May 2013
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Answered by
Practicing since : 2006
Answered : 4909 Questions
Hi, I have posted questions on here about gyno issues I've experienced recently and I can't help but worry (worry wart). My gyno is great and I trust her competency very much. However, the recent issues I've been experiencing have me worried because they are so out of character for me. The most recent (this month) is that I completely and suddenly missed a period, which has never happened, ever, except when I was pregnant. The first thing was that I started spotting "old blood" about 1.5 weeks before I was scheduled to start. That has never happened. I just thought I was starting early, no big deal. I expected it to get heavier. But after about 4 days of very light, stringy brown spotting only when I wiped (no pads necessary), instead of getting heavier, it completely went away. My periods are usually like clockwork, around 28-30 days. My last period started on 5/22, lasted the usual 5-7 days - 1 day light, 3-4 days very heavy, followed by 1-2 progressively light brown, then ends. It was totally normal on 5/22, same pattern and nothing different. I have had no recent stress out of the normal, actually less stress than several months in Jan-March. This month I experienced all the signs of approaching my cycle with some added or abnormally "strong" PMS symptoms - extreme bloating (gained 5lbs, stomach distended), 2 days of SEVERE irritability, on and off cramping but nothing severe (but I usually don't cramp much at all), and severe fatigue. The worst part is the fatigue and bloating have lingered and I have had no relief.

Also new to me, was a hemorrhagic cyst found on transvaginal ultrasound (around Feb) with enlarged ovary. 6 weeks later it was shrinking, which was good news of course.

Anyway, after missing my period and knowing my history, I immediately suspected pregnancy. I took about 6 hpt, all negative, and finally saw the doc. Lab tests revealed negative pregnancy, completely normal FSH, TSH, and normal levels of prolactin. I also had a normal annual exam and pap (even negative HPV) in April.

Could we be missing something? I feel like my doctor has been very thorough, but I'm not quite sure what could be going on and I am afraid that something may be amiss. Should I worry about these changes in the most recent months? I know it is common for some women to sometimes miss a period because of an-ovulation and spot between periods, but this is NOT at all normal for me. Now that pregnancy and peri-menopause have been ruled out, I'm not sure what to think.

Posted Wed, 25 Jul 2012 in Pregnancy
Answered by Dr. Sree Gouri SR 4 hours later
Thanks for the query.

According to your description the possibilities are,
-women taking citalopam which is a SSRI(selective seratonin re uptake inhibitor) can experience absence of periods,
but if you miss two or more periods you have to report to your doctor.

-anemia: as you are having history of anemia it can cause menstrual abnormalities like oligomenorrhea(decreased frequency of periods),

-recent rapid weight gain can cause delayed periods by affecting hypothalamo-pituitary-ovarian axis,

-poly cystic ovary syndrome: can lead to delayed periods by causing hormonal imbalance in it mainly LH level will be raised with LH and FSH ratio greater than 1:1,

-rare possibilities are tubercular endometritis and androgen producing tumors,
don't worry, as you are not having other related symptoms these are least possibilities.

mostly you will have your period soon, if not you discuss above possibilities with your doctor and proceed according to her advice.

the severity of pre menstrual syndrome is also hormone related, estrogen is responsible for fluid retention, weight gain and bloating sensation.
other possible causes are taking diet with excessive salt, drinking excessive caffeine, deficiency of vitamins and minerals.

Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please rate the answer after closing the discussion.
Take care.
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