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Forum Name: Gynecology

Question: I'm almost 18 and have not started my period yet...


 countryfan07 - Sat Dec 30, 2006 8:00 pm

I will be 18 in 4 months and I have yet to start my period. I went to a OBG/YN around 2 years ago and had blood work done to see if I had inbalanced hormones and everything came back normal, so I don't know what is going on. I have developed pubic hair, but my breast aren't really growing much. I also have more body hair and facial hair than a female should have. Please help me. Thanks in advance.
 Dr. Chan Lowe - Sat Dec 30, 2006 9:58 pm

User avatar Primary amenorrhea is, by definition, not having the 1st period by age 16. As such, you qualify in this area. 2 years ago, you would have been 15, so it is likely that your doctor told you to just wait a little longer-a very reasonable approach. You state that all the blood work is normal. Did you have a physical examination that was normal at that point as well?

There are several possible causes for primary amenorrhea. Your development of pubic hair indicates that your body is making some sex hormones. These are divided into two categories, androgens and estrogens. Androgens are responsible for hair growth in general. Estrogens drive breast development. If you have no breast development, one would be suspicious of an estrogen deficiency.

Going further up the chain of signals, two hormones known as LH and FSH stimulate the ovaries to make estrogen, as well as control the menstrual cycle. These hormones (as well as estrogen) can be checked with simple blood tests. Also a general physical exam is important to help rule out physical reasons for absents menses.

Also, the best predictor of when a girl will begin her periods is the age at which her mother started. If mom started at an older age, it is likely that the daughters will also.

There are a few ways to go about finding the cause of your condition. Probably the best starting place is to talk with a gynecologist. You can also consider talking with an endocrinologist. A pediatric endocrinologist will likely be a little more experience with this condition than an adult endocrinologist.

One more question for you. Have you had your growth spurt yet, and if so at what age?

Hope this helps. Keep us updated.

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