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Suggest remedy for irregular menstruation

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Posted on Mon, 14 Dec 2015
Question: Hi
I have been missing my periods since last three months and such kind of situation has never happened before. I have a regular cycle and november is my fourth month and I still don't see any signs of having my period. Could u please suggest me what should I do??
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (20 minutes later)
Brief Answer:
As it has been 3 months, it is time for a trial of progestin.

Detailed Answer:
Hello and welcome,

Missing one's period can be so unnerving. This sort of thing is not uncommon.

First, if there is any chance you could be pregnant, do take a home pregnancy test (urine test). But I do not gather from what you wrote that is a possible issue.

Prolonged stress is a big factor. For example women in demanding school programs can miss their periods for months.

Prolonged, demanding exercise such as competitive distance running can cause this too.

Rapid weight loss, or losing a significant percentage of body fat can stop periods also.

When periods have been missed for 3 months, then it is time for evaluation. Given that you had normal periods before, the usual initial thing to do is to take a short course of a progesterone such as Provera. When you stop taking it, then your period will usually come within a few days. The period may be heavier or lighter or longer or shorter than your regular periods, because you have not actually ovulated.

The way Provera works: If you have a normal amount of estrogen but your body (due to stress, etc) does not ovulate, then the uterine lining does not fully develop and also there is no drop in hormones which usually happens before the period. When you take Provera for a few days, it finishes development of the uterine lining, and when you stop taking it, the lining sheds (and you have a period from he withdrawal of hormones).

IF there is no period after a trial of progesterone, then you should be tested for several hormone levels to make sure there is no endocrine (including thyroid) problem.

IF there is an (expected) withdrawal bleed (period) after progestin, then you can talk with your doctor about whether you are ok with having irregular periods or want to regulate them with something like the birth control pill.

I hope this information helps. Please let me know if I can provide further information or clarification.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh (22 minutes later)
Hi

Thanks for your early response.

Could you please explain me the prescription properly as to how many times in a day I need to have the provera medicine???

Thanks
xxxxxxxxxxxx
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (5 minutes later)
Brief Answer:
Provera 10 mg for 7-10 days.

Detailed Answer:
The dose of Provera for a "progesterone challenge/withdrawal test" is 10 mg and it is taken for 7-10 days. After you finish the last pill, a period should come within 2-7 days.

Provera is by prescription, at least in the US. So you will need to see a doctor for a prescription.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3134 Questions

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Suggest remedy for irregular menstruation

Brief Answer: As it has been 3 months, it is time for a trial of progestin. Detailed Answer: Hello and welcome, Missing one's period can be so unnerving. This sort of thing is not uncommon. First, if there is any chance you could be pregnant, do take a home pregnancy test (urine test). But I do not gather from what you wrote that is a possible issue. Prolonged stress is a big factor. For example women in demanding school programs can miss their periods for months. Prolonged, demanding exercise such as competitive distance running can cause this too. Rapid weight loss, or losing a significant percentage of body fat can stop periods also. When periods have been missed for 3 months, then it is time for evaluation. Given that you had normal periods before, the usual initial thing to do is to take a short course of a progesterone such as Provera. When you stop taking it, then your period will usually come within a few days. The period may be heavier or lighter or longer or shorter than your regular periods, because you have not actually ovulated. The way Provera works: If you have a normal amount of estrogen but your body (due to stress, etc) does not ovulate, then the uterine lining does not fully develop and also there is no drop in hormones which usually happens before the period. When you take Provera for a few days, it finishes development of the uterine lining, and when you stop taking it, the lining sheds (and you have a period from he withdrawal of hormones). IF there is no period after a trial of progesterone, then you should be tested for several hormone levels to make sure there is no endocrine (including thyroid) problem. IF there is an (expected) withdrawal bleed (period) after progestin, then you can talk with your doctor about whether you are ok with having irregular periods or want to regulate them with something like the birth control pill. I hope this information helps. Please let me know if I can provide further information or clarification.