Seeking Guidance: Unexplained Irregular Periods and Symptoms
During my freshman year of high school, I experienced my first menstrual cycle in November. Initially, my periods were irregular, which I learned is common within the first couple of years. However, two years later, my cycle remained inconsistent; I would frequently skip months, sometimes going 3 to 4 months without a period. When my menstruation did occur, it was accompanied by severe discomfort that sometimes left me feeling faint. Eventually, I consulted a gynecologist who conducted an ultrasound and diagnosed me with polycystic ovaries, explaining that I had PCOS (Polycystic Ovary Syndrome). To help regulate my cycles, she prescribed medroxyprogesterone, which I was to take for the first ten days of each month. This treatment initially worked, and I had normal periods for about a year. However, in November 2024, I missed my cycle entirely. I did get my period in December and January of 2025, but then skipped February and March despite continuing my medication. It seemed that the treatment had lost its effectiveness. I sought the opinion of a different gynecologist in my college town, as my previous doctor had retired. This new doctor performed both internal and external ultrasounds in March, confirming the presence of polycystic ovaries and noting that my uterine lining was thin. Despite discussing all my symptoms — including irregular cycles, abdominal weight gain, elevated cholesterol levels despite my healthy diet, frequent ovarian and uterine pain, and significant hair loss — she expressed doubt about my PCOS diagnosis. She ordered blood tests, revealing that my progesterone and estradiol levels were on the lower end, whereas my DHEA levels were higher. My testosterone levels were moderate, but she suspected that the spironolactone I had been prescribed for hair loss by my dermatologist might be affecting those results. Following this, she prescribed a course of estradiol for three weeks, followed by five days of medroxyprogesterone. The result was merely two days of very light spotting. During my recent follow-up appointment, the doctor still maintained her belief that I do not have PCOS. I strongly feel otherwise, echoing the sentiments of my first doctor. The evidence seems clear: my irregular cycles, weight gain around my midsection, high cholesterol, persistent pain, and hair loss strongly suggest the continuation of PCOS. Now, in June, I am still without a period since January. The gynecologist has suggested I try the estradiol and medroxyprogesterone regimen again. I find myself at a crossroads, unsure of the next steps to take. I would greatly appreciate any insights or advice on my situation. Thank you for your help!
Answers (1)
6/18/2025, 7:30:58 PM
OpenHealth AI
It sounds like you are dealing with a complex situation regarding your menstrual health, and I appreciate how frustrating and concerning this must be for you. Let’s break down your situation and explore some actionable steps together.
Main Points:
- You have a history of irregular periods and have been diagnosed with polycystic ovaries (PCOS).
- Current treatments have been inconsistent in regulating your cycles.
- Symptoms you are experiencing (irregular cycles, weight gain, high cholesterol, pain, and hair loss) are common with PCOS.
Explanation:
Polycystic Ovary Syndrome (PCOS) can cause a variety of symptoms, including irregular periods, hormonal imbalances, and fertility issues. It’s understandable that you feel persistent symptoms point towards this condition, especially when you experienced periods of regularity on medication. The variety of blood results and opinions from different doctors can be confusing and disheartening.
When hormonal treatments like the combination of estradiol and medroxyprogesterone aren’t yielding expected results, it can feel overwhelming. It’s essential to trust your intuition about your body while also pursuing effective care.
Next Steps:
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Document Symptoms and Treatments: Keep a diary tracking your cycles, any symptoms (like pain and hair loss), and notes on your experiences with each medication. This may help illustrate patterns that can be valuable for future appointments.
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Consider a Follow-up with Another Specialist: If you feel your concerns are not being adequately addressed, consider seeking a second opinion from another gynecologist who specializes in hormonal disorders or reproductive endocrinology. They may have different insights or treatment options for PCOS.
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Seek Nutritional Support: Given your high cholesterol and weight concerns, look for a registered dietitian experienced in PCOS to tailor a diet that supports hormonal balance and overall health. Focus on a balanced diet rich in whole foods, lean proteins, healthy fats, and low glycemic index carbohydrates.
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Discuss Lifestyle Changes: Regular physical activity can assist in managing PCOS symptoms. Aim for at least 30 minutes of moderate exercise most days to help with weight management and hormone regulation.
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Understand Medication Expectations: If you choose to continue with the current regimen, be sure you have a clear understanding of what to expect. Follow-up with your doctor if the treatment yields no change in a couple of months, so you can discuss alternative strategies.
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Explore Additional Treatment Options: Depending on your symptoms, treatments such as Metformin (often used for insulin resistance in PCOS) or other hormonal therapies could be discussed as alternatives, especially if weight management proves challenging.
Finally, be gentle with yourself during this process. Managing a condition like PCOS is often a journey, and finding the right support and treatment may take time. You deserve a care plan that aligns with your needs and concerns. If you have further questions or need clarification on any steps, don’t hesitate to ask!
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