Why does my period occur only with medicine?

Question

Hello doctor,

I am a 25 year old married girl. I am 5 feet tall and weigh 151 lbs. I am having the problem of irregular periods for the last two years. Medical investigations done several times such as ultrasound and hormone levels. No abnormality was found. Periods occurs with medication. With discontinuation of the medicine, problem reoccurs. Now my periods is normal with medication, but still this time my periods is delayed for 28 days. Please help.

Answer 1

Hi,

Welcome to icliniq.com.

You are suffering from a condition called polycystic ovarian syndrome/polyendocrine metabolic ovarian syndrome (PCOS/PMOS). It is normally found in 5-10 % of girls and is probably of genetic origin. The treatment is lifestyle modification such as healthy diet and regular exercise (at least 45 minutes of sweat inducing exercise daily). You need to reduce weight to achieve healthy BMI (body mass index). With obesity and PCOS/PMOS, there is increased risk of diabetes, hypertension and endometrial cancer. Ideal weight for your height should be less than 121 lbs.

For regularization of menses, you need to take combined oral contraceptive (OCP) like Ovral L (combination of estrogen and progestin) regularly or Progesterone tablets regularly (Medroxyprogesterone acetate 10 mg twice daily for five days, every 30 days) before marriage. After marriage, when you plan for pregnancy, you will need medicines to induce egg formation and ovulation (which is lacking in PCOS/PMOS women). You need to take these medicines regularly to induce period to avoid endometrial cancer in future. If period does not resume spontaneously after weight reduction, there is no alternative to medicines and you have to take them almost lifelong.