Menstrual Irregularities: Causes and Solutions for Women

Menstrual issues

I had sexual intercourse on May 3rd and took emergency contraception within 24 hours.
My period came on May 10th, and then again on June 3rd.
On July 6th, I intermittently visited the gynecologist for pregnancy tests, which showed a single line indicating no pregnancy.
After that, I was prescribed medication to regulate my menstrual cycle, and my period returned.
I continued to visit the gynecologist, who mentioned that I am too thin, which is causing my endometrium to be insufficiently thick.
I have been taking the medication to regulate my cycle until December 9th, when my period came again.
However, this month I hoped to see if my period would come naturally, but it hasn't arrived yet.
Yesterday, I took a pregnancy test, which showed a single line (not pregnant).
It's been several months without a natural period, and I have relied on medication for it to come.
This has been a source of worry for me, which may be contributing to my missed periods.
The doctor mentioned that my nutritional status might be inadequate, as I weigh only 41 kg.
Can you please help me understand what might be causing my missed periods?

judy, 10~19 year old female. Ask Date: 2017/01/13

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I apologize for not being able to provide a diagnosis based on your description.
It may be due to an endocrine disorder.
I recommend visiting a hospital for a detailed examination by an obstetrician-gynecologist.
Wishing you good health.

Reply Date: 2017/01/13

More Info

Menstrual irregularities can be a source of significant concern for many women, and understanding the underlying causes is crucial for effective management. Based on your description, it appears that you have been experiencing irregular menstrual cycles, which have been influenced by several factors, including your weight, hormonal treatments, and possibly stress.

Firstly, it is important to note that a healthy menstrual cycle typically ranges from 21 to 35 days, with bleeding lasting between 2 to 7 days. Irregularities can manifest as missed periods, prolonged bleeding, or spotting between periods. In your case, it seems that your menstrual cycle has been heavily reliant on hormonal medications, which can mask underlying issues.

One of the primary concerns you mentioned is your low body weight (41 kg), which can significantly impact your menstrual health. Low body weight can lead to a condition known as hypothalamic amenorrhea, where the body does not produce enough hormones necessary for ovulation and menstruation. This can occur due to insufficient caloric intake, excessive exercise, or a combination of both. When the body perceives a lack of energy, it may prioritize essential functions over reproductive health, leading to irregular or absent periods.

Your healthcare provider's observation that your endometrial lining is not thick enough could be a direct consequence of your low body weight. The endometrium, which is the lining of the uterus, needs to be adequately developed to support a menstrual cycle. Hormonal medications, such as those you have been prescribed, can help stimulate the lining and induce a period, but they do not address the root cause of the issue.

Additionally, stress can play a significant role in menstrual irregularities. Psychological stress can affect the hypothalamus, which regulates hormones that control the menstrual cycle. If you are experiencing anxiety or stress about your menstrual health, this could further exacerbate the situation.

Given your history and current situation, here are some recommendations:
1. Nutritional Assessment: Consider consulting with a nutritionist or dietitian who can help you develop a balanced diet that supports your overall health and helps you achieve a healthy weight. Gaining weight gradually may help restore your menstrual cycle.

2. Regular Exercise: While exercise is important for overall health, ensure that it is balanced and not excessive. Engaging in moderate physical activity can help regulate hormones, but over-exercising can lead to further complications.

3. Stress Management: Incorporate stress-reducing techniques into your routine, such as mindfulness, yoga, or meditation. These practices can help alleviate anxiety and may positively influence your menstrual cycle.

4. Follow-Up with Your Healthcare Provider: Continue to work closely with your gynecologist. If hormonal treatments are necessary, they can help monitor your progress and adjust medications as needed. It may also be beneficial to explore other potential underlying conditions, such as polycystic ovary syndrome (PCOS) or thyroid issues, which can also affect menstrual regularity.

5. Consider Psychological Support: If stress or anxiety is a significant concern, speaking with a mental health professional can provide additional support and coping strategies.

In conclusion, your menstrual irregularities may be attributed to a combination of low body weight, hormonal imbalances, and stress. Addressing these factors holistically can help restore your menstrual cycle and improve your overall well-being. It is essential to remain proactive in seeking medical advice and support as you navigate this challenging situation.

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