Irregular Periods and Brown Discharge in PCOS Patients

Amenorrhea with scant brown discharge (polycystic)?

Hello doctor, I have been under a lot of stress and workload over the past year.
My menstrual cycle, which used to be every 40 days and regular, has now changed to every two months, and currently, it has been three months since my last period.
I visited a gynecologist who diagnosed me with polycystic ovary syndrome (PCOS).
In the past six months, my two menstrual episodes were so light that I could manage with just one pad for the entire day, and the flow was brownish in color.
Additionally, I have been experiencing recurrent yeast infections for about 4-5 years.
Over the past 1-2 years, I have gained 20 kilograms.
I previously had some autonomic nervous system dysregulation, leading to irritability and uncontrollable binge eating.
I am 160 cm tall and currently weigh 82 kg.
Should I see an endocrinologist or a gynecologist? Should I consider traditional Chinese medicine or Western medicine? Should I go to a gynecological clinic or a hospital? Would taking diabetes medication be beneficial for treating polycystic ovary syndrome? I had taken it for a week before.

Yú ér, 20~29 year old female. Ask Date: 2017/05/16

Dr. Huang Jianzhong reply Obstetrics and Gynecology

In the past year, I have experienced increased stress and a heavier workload.
As a result, my menstrual cycle, which used to occur every 40 days, has changed to every two months, and now it has even extended to every three months.
I visited a gynecological clinic and was diagnosed with polycystic ovary syndrome (PCOS).
Over the past six months, my two menstrual periods have been so light that they resemble the last day of a regular period; I can manage with just one panty liner for the entire day, and the flow has been brown in color.
Additionally, I have been experiencing recurrent yeast infections for about 4-5 years.
In the past 1-2 years, I have gained around 20 kilograms.
I previously had some autonomic nervous system dysregulation, leading to irritability and uncontrollable binge eating.
My height is 160 cm, and my weight is now 82 kg.

1.
Should I see an endocrinologist or a gynecologist?
Answer: Endocrinologist, I have already seen a gynecologist.
2.
Should I consult a traditional Chinese medicine practitioner or a Western medicine doctor?
Answer: Western medicine.
3.
Should I go to a gynecological clinic or a hospital?
Answer: Hospital.
4.
Will taking diabetes medication help with polycystic ovary syndrome?
Answer: Yes, it will help.

Reply Date: 2017/05/16

More Info

Understanding irregular periods and brown discharge in patients with Polycystic Ovary Syndrome (PCOS) can be complex, especially when compounded by factors such as stress, weight gain, and recurrent infections. Your situation highlights several important aspects of PCOS and its management.

Firstly, it is essential to recognize that PCOS is a hormonal disorder that can lead to irregular menstrual cycles, often characterized by prolonged intervals between periods, as you have experienced. The brown discharge you are observing is typically old blood, which can occur at the beginning or end of a menstrual cycle. In the context of PCOS, this can be attributed to hormonal imbalances that affect the normal shedding of the uterine lining. When periods are infrequent, the lining can build up and may not be expelled in a typical manner, leading to spotting or brown discharge.

The significant stress you mentioned can also exacerbate hormonal imbalances. Stress impacts the hypothalamus, which regulates the hormones responsible for the menstrual cycle. This can lead to further irregularities in your cycle. Additionally, weight gain, particularly in the context of PCOS, can worsen insulin resistance, which is a common issue in these patients. Insulin resistance can lead to increased androgen levels, further complicating the hormonal landscape and contributing to irregular periods.

Given your symptoms and history, it is advisable to consult with a healthcare provider who specializes in either endocrinology or gynecology. An endocrinologist can help assess your metabolic health, particularly regarding insulin resistance and its implications for your menstrual health. On the other hand, a gynecologist can provide insights into the reproductive aspects of PCOS, including the management of irregular periods and any associated symptoms like brown discharge.

In terms of treatment, lifestyle modifications are often the first line of defense. This includes weight management through diet and exercise, which can significantly improve insulin sensitivity and, consequently, menstrual regularity. Medications such as metformin, commonly used in diabetes management, can also be beneficial for PCOS patients, as they help improve insulin sensitivity and can promote regular ovulation.

If you are considering medication, it is crucial to discuss this with your healthcare provider. They can evaluate your specific situation and determine whether medications like metformin or hormonal contraceptives (which can help regulate periods) are appropriate for you. Hormonal contraceptives can also help manage symptoms like excessive hair growth and acne, which are often associated with PCOS.

As for recurrent yeast infections, it may be worthwhile to address this issue separately. Chronic infections can be a sign of underlying imbalances, including those related to blood sugar levels. A healthcare provider can help determine the best course of action to manage these infections effectively.

In summary, your symptoms of irregular periods and brown discharge are likely related to the hormonal imbalances associated with PCOS, compounded by stress and weight gain. A multidisciplinary approach involving both endocrinology and gynecology may provide the most comprehensive care. Focus on lifestyle changes, and consider discussing medication options with your healthcare provider to manage your symptoms effectively. Regular follow-ups will be essential to monitor your condition and adjust treatment as necessary.

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