Question for Betty.

I started my period at age 12 and now I'm 20, and still have irregular periods.  I've tried birth control pills to help regulate it and I hate the way it made me feel and I've switched to 4 or 5 brands and I can't stand it.  I was wondering if there was anything I can do or take other than birth control to get a regular period?  I'm not sexually active.  Any suggestions?

Betty's Answer.

Thanks for the question as your frustration with dealing with your irregular menstrual periods and hormone treatment is evident. Because no two women are exactly alike and recommendations can vary from one person to another, it is important to seek guidance from a healthcare provider who is familiar with your individual situation.

In general, menstrual cycle disorders can cause a woman's periods to be absent or infrequent. If you miss more than three menstrual periods (either consecutively or over the course of a year) you should see your healthcare provider for an evaluation.

The evaluation will include a complete history, physical and often labs for hormone levels, thyroid, and metabolic testing.

A thorough history can give clues to why you are having menstrual cycle disorders such as symptoms of discharge from the breasts, hot flashes, masculine features, headaches and impaired vision.  Medications, herbs, vitamins, recent stress, changes in weight, diet, exercise patterns, and illnesses may also affect menstrual cycles.

Menstrual cycle disorders can result from conditions that affect the hypothalamus, pituitary gland, ovaries, uterus, cervix or vagina.  The hypothalamus releases GnRH (gonadotropin releasing hormone), a hormone that influences when a woman has a menstrual period.  The hypothalamus is sensitive to many factors, including low body weight, having very little body fat, a very low calorie or fat intake, emotional stress, strenuous exercise, and some medical conditions or illnesses. 

Ovarian conditions which effect menstrual periods include polycystic ovary syndrome and ovarian failure. 

The goal of treatment for irregular menstrual periods is to correct the underlying condition. 

A common cause is polycystic ovary syndrome (PCOS) a chronic condition that causes infrequent periods and an excess of androgens (male hormones); this often leads to acne, excessive facial hair, high cholesterol levels and obesity.  Treatment for PCOS would be to alleviate the symptoms of androgen excess, reestablish normal menstrual cycles, and prevent the long-term complications of this disorder (increased risk to diabetes and coronary heart disease).

Another cause, functional hypothalamic amenorrhea, may be resolved with certain lifestyle changes involving increasing caloric intake, gaining weight, adjusting exercise and resolving emotional stress.

Treatment of medical conditions, such as hypothyroidism and diabetes may restore normal menstrual period in some women.

So, as I emphasized at the start, every woman is unique and treatment for irregular menstrual periods needs to focus on correcting any underlying condition.

Please see your healthcare provider or make an appointment at the SHCC for further evaluation.