OpenHealth Q&A

Navigating Hormonal Challenges at 21

At just 18 years old in 2022, I found myself facing an unexpected situation when my menstrual cycle abruptly ceased. Despite my dedication to regular exercise, my workouts were not extreme enough to warrant such a change. I have always prioritized a nutritious diet, particularly as I have been managing type 1 diabetes for the past decade, maintaining a steady A1C level of 5.3. Everything seemed to be functioning well; however, after undergoing lab tests, I discovered that my estradiol levels were shockingly low at 15, indicative of someone experiencing menopause. While my testosterone and thyroid levels were unremarkable, my DHEA was alarmingly elevated at 389. As my period disappeared for an entire year, I began to notice unwanted weight gain, despite adhering to a strict low-carb regimen. Additionally, I developed a fibrous osteous lesion in my skull, resulting in a deficit in my bone density that I suspect is linked to the lack of estrogen production. Seeking answers, I consulted with a gynecologist who conducted a thorough evaluation for PCOS. While I exhibited many symptoms, my uterine lining was unusually thin rather than thick, which ultimately prevented her from diagnosing me with that condition. An MRI of my pituitary gland revealed a benign cyst, and I visited multiple specialists at UCSF who ruled out various diseases, all tests returning negative. Their conclusion was hypothalamic amenorrhea, but without any effective solutions presented. On a friend's suggestion, I approached a thyroid specialist who speculated that, despite my normal thyroid panel, I may have hypothyroidism stemming from my type 1 diabetes. An ultrasound yielded no abnormalities with my thyroid, yet he prescribed me thyroid medication. To my surprise, shortly after starting this treatment, my period returned and remained regular for several months. During this period, my estradiol levels increased from 18 to 78. However, my diabetes specialist expressed concern regarding the thyroid medication, as my T3 and T4 levels were never low. Caught between conflicting opinions, I noticed my menstrual cycle continued regularly after initiating the medication. Additionally, I began taking Spironolactone to manage my acne and elevated DHEA levels. Though it was effective for my skin, it also caused my cycle to fluctuating unpredictably, eventually ceasing altogether. Additionally, my acne worsened in the absence of my period, and noticeable changes in my breast tissue occurred, leading to significant weight gain in my stomach and arms. With these health changes, I decided to start birth control, which offered some relief but left me feeling frustrated due to the absence of ovulation—something that felt counterintuitive after years of trying to balance my hormones. Recently, I made the choice to discontinue both the thyroid medication and birth control, as my dosage had kept me in a hyperthyroid state. Miraculously, I experienced a few menstrual cycles, something I hadn’t seen in years without thyroid support. However, follow-up blood tests showed my DHEA had risen even higher to 462. My T3 and T4 levels were normal, but my testosterone levels were slightly elevated. While my estradiol was measured at 52, it still falls short of what is appropriate for someone my age. At 21, I find myself grappling with perplexing hormonal dysfunction, often receiving vague feedback from various doctors who acknowledge abnormalities in my blood work without providing a clear diagnosis. I’ve seen plenty of success stories online where women attribute their healing to dietary changes, stress management, and regular exercise—yet I am doing all these things and feel utterly drained. Despite consuming supplements and herbal remedies aimed at bolstering hormone health, I can’t shake the feeling that there’s a piece of the puzzle missing. Having lived most of my life without hormonal issues, the dramatic shift I experienced post-pandemic has left me feeling bewildered and desperate. I would greatly appreciate any insights or suggestions from those who may have experienced similar struggles!

Answers (1)

6/16/2025, 7:20:58 PM

OpenHealth AI

It sounds like you’ve been on a challenging journey with your hormonal health, especially given the interplay with your type 1 diabetes, and I appreciate how overwhelming and confusing this situation can be. Your experiences suggest hormonal dysregulation, particularly concerning your estradiol, DHEA, and menstrual cycle. Let's break down the key areas to address and offer steps for potential management.

Key Points:

1. Hormonal Imbalance: Your low estradiol and fluctuating DHEA levels indicate hormonal dysfunction that may be influenced by various factors, including stress, medication usage, and underlying health conditions.
2. Sustainable Lifestyle Changes: It’s important to evaluate if your current dietary and lifestyle approaches are fully supporting your hormonal balance.
3. Integrated Care Approach: Ongoing collaboration with specialists is critical, as managing hormonal health can often require a multifaceted approach.

Explanation:

Hormonal issues, particularly in young women, can arise from several causes including stress, dietary habits, lifestyle factors, and underlying health conditions such as hypothalamic amenorrhea, which you’ve been informed about. The body’s hormonal balance can be sensitive, and interventions such as medications you’ve tried may have both positive and negative impacts on your overall health. Also, considering your type 1 diabetes, it’s possible that fluctuations in blood sugar and insulin levels could be interacting with your hormonal health.

Next Steps:

1. Monitor Menstrual Cycle and Symptoms: Keep a detailed diary of your menstrual cycles, mood changes, weight fluctuations, and any other symptoms you experience. This will help identify patterns that may guide your management more effectively.

2. Reassess Dietary Intake: Consult with a registered dietitian specializing in hormonal health or diabetes who can help tailor a diet plan that meets your nutritional needs while supporting hormonal balance. Consider focusing on a balanced intake of healthy fats, proteins, and carbohydrates that helps maintain stable blood sugar levels.

3. Stress Management Techniques: Incorporate stress-reducing activities such as yoga, meditation, or gentle exercise which can benefit hormonal health. Mindfulness practices can significantly impact hormonal regulation and improve overall well-being.

4. Regular Exercise: While you already prioritize exercise, consider moderate strength training and aerobic activities that can help maintain a healthy weight and potentially support hormone regulation.

5. Follow-Up with Specialists: Since you have seen various specialists, it may be beneficial to compile all findings and seek a comprehensive evaluation from an endocrinologist or a reproductive endocrinologist who is experienced in managing complex hormonal imbalances. You may want to inquire specifically about the interactions between your medications, type 1 diabetes, and hormonal health.

6. Consider Natural Supplements: If you have not already, discuss with a healthcare provider about the safety and appropriateness of supplements like omega-3 fatty acids, vitamin D, or adaptogens that might help support hormonal health, keeping in mind that these should complement, not replace, conventional management.

Taking a proactive approach while collaborating with healthcare professionals who take your unique situation seriously is key to finding a balance that feels right for you. You're not alone in this, and many have found their path through similar challenges. Keep advocating for your health and well-being!