Question for Betty.
 
I am 25 years old, healthy, within my body weight norm, I exercise, eat regularly, my stress levels have been up and down but my major concern is that I don't get my periods regularly.  It's been a little over 3 months since my last one and this is the longest its gone.  I've taken 3 pregnancy tests, all negative, I have no weird symptoms, my paps are normal, I've talked to two doctors and both say its normal, and that if I go 6 months without a period then I should go back in, does this seem normal?  It kind of freaks me out not knowing why I'm not getting my period every month like everyone else. It's never been regular and my sisters and mom are the same way.  I just feel like the big weirdo for some reason.  I've had blood work done last year and hormone checks all normal, and an ultrasound done of my ovaries when I was 17.  All normal.  Can I do or eat anything that will help?  Thank you.
 
Betty's Answer.
 

Thanks for your question dealing with absence of menses (amenorrhea). You have been concerned enough to have had at least 2 visits to health care providers, have taken 3 pregnancy tests, and have had labs done last year as well as an ultrasound of your ovaries 8 years ago. So this is an ongoing concern for you, and one that "freaks" you out. You mention that your sister and mother also have irregular menses, as I assure you do many other women.  You are not alone, and certainly not the "big weirdo" that you express. Every woman is unique, and causes for amenorrhea can vary. 

This is not a new problem, but is causing increased stress at this time, which is a great reason to follow up with you health care provider for further evaluation.  A new history and exam may identify the cause of your amenorrhea, or you may need to repeat previous labs or ultrasound. With discussion with your health care provider, you may want to wait up to an additional 3 months, or begin treatment at this time.

Amenorrhea can result from dysfunction of the hypothalmus, pituitary, ovaries or uterus.  You share that you have a body weight within recommended level, you exercise, eat regularly, and have up and down stress levels. Weight loss, eating disorders, high levels of exercise, stress, and severe or prolonged illness can cause amenorrhea.  You had lab tests done one year ago which may have included serum prolactin, FSH, and TSH, which would point out problems with the pituitary or thyroid glands. You also had an ovarian ultrasound eight years ago, which was normal, and was probably to look for polycystic ovary syndrome. 

There may be multiple reasons why you are having irregular menses. It is not necessarily a negative thing to miss occasional menses, unless there is a treatable underlying cause. Your body may just react to stress with stopping menses. To attempt to achieve monthly menses, your health care provider may have you try a trial of oral contraceptives, or may recommend behavioral health changes (stress reduction, nutritional diet changes, and adequate exercise). 

Thank you again for your question.