Doctors Lounge - Gynecology Answers
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Forum Name: Gynecology
Question: Irregular Menstrual Cycle
|mally - Mon Dec 12, 2005 9:08 pm||
I have not had a period in over a year. I have had one instance where I had some clotting and discharge for about a week but I would not consider it a "normal period". Since that happened ,about three weeks ago, I have had occasional spotting and discharge. The discharge is clear and watery and the blood is almost pink. I don't have any insurance and I can't afford to go to the doctor. I am not sure what I should do. Is there anything that I can do to make my period come on a regular basis?
|Dr. Tamer Fouad - Mon Jan 02, 2006 5:01 pm||
To be able to treat your case we have to find out what is causing your cycles to stop. Unfortunately, this will need an evaluation by a doctor. There is no replacement for that.
Let me go through some of the causes of this condition and what should be done about it.
Secondary amenorrhea is defined as absence of menstruation for three normal menstrual cycles or 6 months in a woman with previously regular menstruation.
Causes include pregnancy, ectopic pregnancy (especially if you have had a tubal ligation), use of hormonal birth control methods (such as birth control pills or hormonal injections or implants), recently stopping birth control pills or breast-feeding. Other causes such as rapid weight loss, obesity, excessive exercise or participation in endurance sports, menopause, severe stress or lifestyle change, use of certain medications and hormone imbalance. Other, more serious causes of missed periods include tumors, pituitary disorders, and other glandular problems involving the ovaries, thyroid, or adrenal glands. These problems are rare. In addition there are abnormalities in the anatomy of the reproductive organs and chromosomal etiologies.
A pregnancy test (urine or serum hCG) should be performed in a reproductive-age woman with normal secondary sexual characteristics and normal pelvic examination findings who has amenorrhea.
If the results of the pregnancy test are negative, amenorrhea should be evaluated using the following assessments: serum TSH and prolactin levels, FSH levels, estrogen status and evaluation of pituitary and hypothalamic function.
1. Jonathan S. Berek: Novak's Gynecology, 13th ed. Lippincott Williams & Wilkins, 2002.
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