What causes missed periods, sweet cravings, and facial hair?

Question

Hi doctor,

I am a 21-year-old female, I weigh 90 pounds, and have not gained or lost much weight. My last period was 3 months ago, and since then, I have been having irregular periods. I also tend to want sugar after meals and have had a few facial hairs ever since. I am also experiencing random PMS symptoms and vaginal discharge.

I have had sex with my boyfriend a few times, and we mostly use condoms, but there have been a few short periods of unprotected sex. I have been experiencing these symptoms for some time now, and I am asking for medical advice in order to rule out a possible hormonal imbalance or any other underlying condition.

What to do?

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Considering your age, low weight (BMI around 17.6), irregular periods, sweet cravings, and facial hair, the most likely cause is a hormonal imbalance, possibly PCOS (polycystic ovary syndrome) or hypothalamic amenorrhea due to low body weight.

The facial hair may mean your body is making more male hormones, which can happen with PCOS. PCOS is less common in very thin women, but it is still possible. Wanting sweets often may be a sign of insulin resistance, and this can happen even if you are underweight.

Even though you usually use condoms, please take a urine pregnancy test to be sure. A short time of unprotected sex can still carry a small chance of pregnancy.

To find the cause of your symptoms, I recommend these tests:

A pelvic ultrasound to check your ovaries for cysts and measure your endometrial lining.
Blood tests should include TSH (thyroid-stimulating hormone), prolactin, free testosterone, DHEAS (dehydroepiandrosterone sulfate), fasting insulin and glucose, and a complete blood count.

If you have PCOS, you may be prescribed Metformin to reduce insulin resistance and low-dose hormonal contraceptives to regulate your cycle and to decrease facial hair.If it is hypothalamic amenorrhea, the main treatment is nutritional support and weight restoration (even a small gain can restart cycles).

Your low weight is a key clue. Please discuss this with a doctor who can guide you safely. You are doing the right thing by seeking answers. Book a consultation soon, you deserve to have a clear plan!

I hope this information helps you.

Feel free to ask further queries.

Thank you.