How to manage irregular menstruation in a 25-year-old?

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Irregular menstruation, especially amenorrhea (absence of menstruation for several months), can result from several underlying causes. Given your history and that your period has now been absent for nearly five months, this is considered secondary amenorrhea, which means a woman who previously had regular periods stops menstruating for three months or more.

Here are some common possible causes to consider:

Polycystic ovary syndrome (PCOS) is the most common cause of irregular or missed periods in young women.

The signs may include:

1. Acne.

2. Weight gain.

3. Excessive facial or body hair.

4. Ovarian cysts.

5. Hormonal imbalance is central (e.g., elevated androgens, insulin resistance).

6. Thyroid disorders: Both hypothyroidism and hyperthyroidism can disrupt the menstrual cycle.

Symptoms of hypothyroidism include:

1. Fatigue.

2. Weight gain.

3. Cold intolerance.

4. Dry skin.

Symptoms of hyperthyroidism include:

1. Anxiety.

2. Weight loss.

3. Palpitations.

4. Heat intolerance.

Prolactinoma or elevated prolactin:

1. A benign pituitary tumor can cause high prolactin levels, which suppress menstrual hormones.

2. Premature ovarian insufficiency (POI): It is also called early menopause. Less common at 25 years, but should be ruled out if no other causes are found.

3. Stress, rapid weight changes, or excessive exercise: These can affect your hypothalamic-pituitary-ovarian (HPO) axis.

4. Pregnancy: Always the first thing to rule out, even if you think it is unlikely.

I suggest you do the following:

Please consider seeing a gynecologist or endocrinologist for a workup. The following tests are typically ordered:

1. Pregnancy test (urine or blood).

2. Pelvic ultrasound (to evaluate ovaries and uterus).

Blood tests to be done include:

1. TSH (Thyroid-stimulating hormone) levels (thyroid function).

2. Prolactin levels.

3. Follicle-stimulating hormone (FSH) and LH (leutinizing hormone) (pituitary hormones).

4. Estradiol levels.

5. Testosterone and dehydroepiandrosterone-sulfate (DHEA-S) (androgen levels).

6. Glycated hemoglobin (HbA1c) and fasting insulin (if PCOS suspected).

You must get worried in the following situations:

1. If you go six months without a period.

2. If you experience abnormal hair growth, sudden weight gain or loss, or milk-like breast discharge.

3. If you are trying to conceive and not ovulating.

Would you like a sample checklist to bring to your doctor or a basic PCOS symptom tracker?

Kindly consult a specialist doctor, talk with them, and take medications with their consent.

I hope this helps.

Thank you.