Why is my young cousin not getting her period till now?

Hi,

Welcome to icliniq.com.

I can understand your concern.

Normal periods occur when the hormone axis between the brain and ovaries matures, which usually occurs around 19-21 years of age. So, I suggest you wait. Her periods will get regularized on their own. The scan is not significant, once her periods become regular after the hormones are produced at normal levels, and the uterus will grow to a mature adult level. There is no need for any medications.

From her history, I presume that she has PCOD (polycystic ovarian disease). PCOD is a congenital condition, which means it is a genetically programmed condition, and you get it from your parents. When you suddenly put on weight, this cholesterol gets converted to estrogen hormone (like you would have noticed obese men developing breasts).

Young obese girls, who develop periods at a younger age, will have high levels of estrogen hormone or female hormone. In your body also when the fat (which acts as a reserve for tomorrow), is more than normal, it gets converted to a hormone that maintains the balance between FSH (follicle-stimulating hormone) from the brain and the ovarian hormone. Follicle-stimulating hormone, as the name suggests, stimulates the follicles in the ovaries. But once the follicle is big enough to ovulate, the FSH is suppressed by the same estrogen hormone from the ovary.

But when the same estrogen hormone comes from fat, the brain gets confused, and the follicle growth stops earlier at a stage when the size of the follicle is small and hence will not rupture. In the next scan, you will see all these follicles as polycystic ovaries.

This is usually associated with obesity, irregular cycles, absence of periods for a few months, followed by heavy periods with clots and fleshy masses later, or spotting that occurs on and off. This causes thyroid abnormalities and prolactin problems indirectly.

You develop that extra pad of fat around the mid portion of the body, especially in the waist, thighs, and breasts. There will be no fat beyond the elbows and knees. Excessive growth of body hair, hair fall, a dark shade over the lower half of the face, acne, oily face, and black skin over the back of the neck, inner thighs, and under the breasts can be noticed. You may have a family history of diabetes, especially if your father or his family.

This will not allow ovulation to occur on time, and so one cannot get pregnant till the condition is treated. It also increases the chances of early pregnancy abortions. But this has a solution.

Your weight has to be as follows:

Weight (in pounds) = Height (in feet and inches) -100

Your expected weight should be 114-123 pounds.

Once you reduce your weight to the normal range, you will not require any medicines to get your period or to get pregnant. You will also have a healthy pregnancy.

I suggest you do the following to reduce your weight:

1. Do not try to reduce your weight by fasting. Avoid consuming junk foods, fast foods, and red meat. Reduce taking snacks in between meals.
2. Have food with low calories but high protein.
3. Exercise regularly and focus especially on the waist and hip area, do aerobics, yoga, and brisk walking (you must swing your hands well while walking). Try to reduce 4.4 to 8.8 pounds a month. Do not be hasty in reducing the weight, as it will be difficult to maintain.

As soon as she reduces her weight by two to four pounds, she will be able to observe the changes.

I hope I have clarified your query. Do write back if you have any further queries.

Thank you.