I have PCOD and cysts. Why am I not getting my period?

Hello,

Welcome to icliniq.com.

I understand your concern.

You have polycystic ovarian disease (PCOD), and it has been four months without periods, along with a follicular cyst. This suggests that your ovulation cycles are disturbed. When periods do not occur for such a long time, we usually become concerned about thickening of the endometrium inside the uterus. That needs to be addressed before thinking about regularizing cycles. The possible cause may be hormonal imbalance due to PCOD and anovulation, leading to cyst formation and skipped periods.

Before deciding on the next steps, the following investigations are advisable:

• Pelvic ultrasound (transvaginal sonography - TVS if possible) to check endometrial thickness and cysts.

• Hormone profile: Luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), prolactin, anti-müllerian hormone (AMH), and fasting insulin.

• Blood sugar and lipid profile.

The following conditions need to be ruled out:

• Hypothyroidism.

• Hyperprolactinemia.

• Premature ovarian insufficiency (less likely if PCOD is confirmed).

I would suggest the following measures:

If the endometrium is thick, sometimes a short course of Progesterone tablets is prescribed to bring withdrawal bleeding. After that, cycle regulation can be achieved with combined oral contraceptive pills or cyclic Progesterone. Alongside lifestyle management is the real long-term fix for weight control: regular exercise and a balanced diet. For the cyst, follicular cysts usually resolve on their own, and a repeat scan in six to eight weeks is often sufficient.

Ultrasound reports and hormone tests should be reviewed before starting any medicines. Uploading these reports or having a video consultation with a doctor is safer for proper guidance. It is not advisable to experience four to five months of consecutive periods without menstruation, as this can lead to endometrial thickening. Consulting a local gynecologist in person is strongly recommended.

Preventive measures include:

• Exercise daily and aim for weight management.

• Cut down on sugar and refined carbohydrates.

• Maintain a regular sleep schedule.

• Follow up with hormone levels every six months.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.