Menstrual Irregularities: Causes and Solutions

Menstrual issues

Hello Doctor, since my last menstrual period on October 26, 2016, my menstruation has not returned, and I have not engaged in any sexual activity.
I am a nursing student and I am under a lot of pressure from my studies.
My sleep is irregular, and I get less than 8 hours of sleep each night.
The last time I had my period was due to taking medication to induce menstruation from a Western medicine doctor.
I visited two gynecologists, both of whom prescribed me medication to induce my period.
After taking it, I did have a period, but the flow was not substantial.
After that, by the next month, my period did not return! I then considered Traditional Chinese Medicine to regulate my body and started taking herbal medicine, which has improved my condition, making me feel less cold.
However, my menstruation still has not returned; it has been over 5 months, almost half a year.
I have been taking herbal medicine for the past two to three months, but my period has still not come back for nearly half a year, and I am really worried! I wonder if I have developed a condition of having periods only every six months.
I started menstruating in the second year of junior high school, during which I had no significant stress, went to bed before 10 PM most nights, and occasionally stayed up late, but my periods were regular.
Should I go to another hospital for further evaluation? Or...? Thank you!

Hsuan, 10~19 year old female. Ask Date: 2017/04/07

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Since my last menstrual period on October 26, 2016, I have not had my period, and there has been no sexual activity in between.
As a nursing student, I am under a lot of pressure from my studies.
My sleep is irregular, and I get less than 8 hours of sleep each night.
I remember that my last menstrual period came after I took medication to induce menstruation from a Western medicine doctor.
I visited two Western gynecologists, both of whom prescribed me medication to induce my period.
After taking the medication, my period did come, but the flow was not heavy.
However, after that, I waited until the next month, and it did not come again! I then considered traditional Chinese medicine to regulate my body and started taking herbal medicine, which has improved my condition and made me feel less cold.
However, my period still has not returned; it has been over 5 months, almost half a year.
I have been taking herbal medicine for the past two to three months, but my period has still not come for nearly half a year, and I am very worried! I wonder if I have developed a condition where I only menstruate every six months.
I started menstruating in the second year of junior high school, during which I had no significant stress, went to bed before 10 PM, and occasionally stayed up late, but my periods were regular.
Should I go to another hospital for confirmation? Or...
? Thank you!
Answer: First, get a blood test to check hormone levels and have an ultrasound done.
If everything is normal, inducing menstruation every three months may be sufficient.
If you are overweight, you should consider losing weight.

Reply Date: 2017/04/07

More Info

Menstrual irregularities can be a source of significant concern for many individuals, particularly when they experience prolonged absence of menstruation, known as amenorrhea. In your case, it has been nearly six months since your last menstrual period (LMP), and you have not engaged in any sexual activity. This situation can be attributed to several factors, including stress, lifestyle changes, and potential underlying medical conditions.

Firstly, stress is a well-known factor that can disrupt the menstrual cycle. As a nursing student, it is understandable that you may be experiencing high levels of stress due to academic pressures. Stress can lead to hormonal imbalances that affect the hypothalamus, which plays a crucial role in regulating the menstrual cycle. When the hypothalamus is impacted, it can result in delayed or missed periods.

Additionally, irregular sleep patterns and insufficient sleep can also contribute to menstrual irregularities. The body requires adequate rest to maintain hormonal balance, and chronic sleep deprivation can exacerbate stress levels and further disrupt the menstrual cycle. It is recommended to aim for a consistent sleep schedule and prioritize sleep hygiene to support overall health.

You mentioned that you have previously taken medication to induce menstruation, but the results were not sustainable, and your period did not return without intervention. This could indicate that the underlying issue is not solely related to hormonal levels but may also involve other factors such as lifestyle, nutrition, or even potential medical conditions like polycystic ovary syndrome (PCOS) or thyroid disorders.

The fact that you have sought treatment from both Western medicine and traditional Chinese medicine (TCM) is commendable, as it shows your willingness to explore different approaches to restore your menstrual health. TCM can be beneficial in addressing imbalances in the body, and it may help improve symptoms such as coldness and overall well-being. However, it is essential to ensure that any treatment you pursue is evidence-based and monitored by a qualified healthcare provider.

Given that you have not had a menstrual period for nearly six months, it is advisable to seek further evaluation from a healthcare professional. A thorough examination, including blood tests to assess hormone levels (such as estrogen, progesterone, and thyroid hormones), can help identify any underlying conditions that may be contributing to your amenorrhea. Additionally, imaging studies like an ultrasound may be warranted to evaluate the ovaries and uterus for any abnormalities.

In conclusion, menstrual irregularities can arise from a combination of stress, lifestyle factors, and potential medical conditions. It is crucial to address these factors holistically and seek appropriate medical evaluation to determine the underlying cause of your amenorrhea. Regular follow-ups with a healthcare provider will help monitor your progress and guide you toward effective treatment options. Remember, you are not alone in this journey, and seeking help is a positive step toward regaining your menstrual health.

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