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Q. I did not get my period for a few months with rapid weight gain. Please help.

Answered by
Dr. Shaikh Sadaf
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Oct 04, 2020

Hello doctor,

I am an 18-year-old female. I have a history of rapid weight gain over 3 months with severe stretch marks over breasts, fullness around the face and upper body. At the time of blood work, I was taking a low dose birth control pill (Blisovi 24 Fe) and multivitamin and biotin. I continued biotin for some hair loss. But I stopped both after having my blood test. I did not get my period until now. Please help.

Dr. Shaikh Sadaf

Diabetology Endocrinology
#

Hello,

Welcome to icliniq.com.

I just read your query. There are three differential diagnoses.

1. Drug-induced Cushing syndrome.

2. Polycystic ovarian syndrome.

3. Pregnancy.

For Cushing's syndrome, do 24-hour urinary free cortisol, low dose Dexamethasone suppression test is suggested, if positive, then high dose Dexamethasone suppression test is recommended.

For polycystic ovarian syndrome diagnosis, ultrasound pelvis, LH (luteinizing hormone), FSH (follicle-stimulating hormone) ratio, testosterone levels, and TSH are recommended.

For pregnancy, a serum beta hCG (human chorionic gonadotropin) test is recommended. Once these tests are done, the diagnosis will be clear.

I hope this helps.


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Thank you doctor,

Can it become Cushing's if I do not take any medication?

Dr. Shaikh Sadaf

Diabetology Endocrinology
#

Hello,

Welcome back to icliniq.com.

Yes, if the offending drug has been stopped and still, the symptoms mentioned persist. The cortisol levels remain high, then it can still be Cushing's, and the type of Cushing's has to be identified using the low dose Dexamethasone suppression test and high dose Dexamethasone supression test as well to rule out the pituitary cause, adrenal cause, or ectopic cause. Also, alcohol consumption and PCOS cannot be ignored here.


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