What led to my missed period?

Question

Hi doctor,

I have not had my period. My last regular cycle was some time ago, and since then, I have not had any bleeding.

This is extremely unusual for me, as my periods are always regular. I have also felt a little bloated for the past two weeks.

Please advise.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Since you have missed your period for over three months, this is considered secondary amenorrhea (the stopping of periods after previously normal cycles).

Possible causes include:

Pregnancy – the most common cause.This should always be ruled out first with a urine or blood pregnancy test.
Polycystic ovary syndrome (PCOS) – often associated with weight gain, irregular or missed periods, bloating, acne, or excess hair growth.
Thyroid imbalance (hypothyroidism or hyperthyroidism).
High prolactin levels (hyperprolactinemia).

It is best to consult a gynecologist or endocrinologist for evaluation. They will likely request:

Urine or serum pregnancy test.
Hormone profile:

LH (luteinizing hormone), FSH (follicle stimulating hormone).
Prolactin.
Thyroid hormones such as TSH (thyroid stimulating hormone), T3 (triiodothyronine), and T4 (thyroxine).
Estrogen, progesterone.
Testosterone (to screen for PCOS).

Pelvic ultrasound – to check for ovarian cysts or uterine issues.

Additionally, secondary amenorrhea can sometimes result from significant stress, sudden weight changes, or excessive exercise, which can disrupt hormone balance.Maintaining a detailed record of your menstrual history, symptoms, and lifestyle factors can help your doctor identify the underlying cause.

Early evaluation is important, as untreated hormonal imbalances may affect fertility and overall health.Managing underlying conditions, such as PCOS or thyroid disorders, often helps restore normal menstrual cycles.

Your gynecologist may also recommend lifestyle modifications, including a balanced diet, regular exercise, and stress management, alongside medical treatment.

Follow-up visits are important to monitor hormone levels and assess response to treatment.In some cases, additional tests like an MRI (magnetic resonance imaging) may be needed if prolactin levels are persistently high.

I hope this has helped you.

Please feel free to reach out to me again if you have further queries.

Thank you.