Is Medication the Only Solution for Irregular Periods?

Q: Is Medication the Only Solution for Irregular Periods?

Hello Ms. <br>Ting： Based on the laboratory data, your condition appears to be polycystic ovary syndrome (PCOS), as your LH levels are significantly higher than your FSH levels (more than twice). <br>Additionally, your testosterone levels are also elevated. <br>You meet more than

Is it only possible to induce menstruation through medication?

Hello Doctor, I have been experiencing irregular menstrual cycles since I started menstruating in sixth grade.
Sometimes my period comes every twenty days, other times it takes over forty days, and during college, I even went two to three months without a period.
I had several check-ups at a major hospital (Hospital A) during college, where blood tests and ultrasounds showed normal results.
The doctors said it was due to stress.
I also tried traditional Chinese medicine to regulate my body, but my menstrual cycles remained very irregular.
In the last couple of years, I have even gone three to four months without a period.
In November 2016, after not having my period since August, I went to Hospital A for an examination.
The ultrasound showed normal ovaries, but my blood tests revealed FSH at 4.34 (mlU/ml), LH at 13.23 (mlU/ml), testosterone at 62.85 (ng/dl), and estradiol at 38 (pg/ml).
The doctor diagnosed me with polycystic ovary syndrome (PCOS), stating that although the ultrasound looked normal, the blood test results were abnormal.
He prescribed estrogen and progesterone for one week to induce menstruation and advised that I should take medication to induce my period if it did not come for two to three months.
After taking the medication, my period came on December 2, 2016, but after that, I did not have another period until March 2017.
I then went to another major hospital (Hospital B) for further examination.
The doctor there said my ovaries looked very healthy on the ultrasound and that there was no need for blood tests.
He mentioned that many women experience missed periods and suggested using a medication to induce menstruation or an ovulation trigger if I wanted to conceive.
He prescribed me an injection to induce my period (which I saw contained progesterone), and my period came seven days after the injection on March 17, 2017.
However, as of now, May 22, 2017, I have not had my period again.
I would like to ask you, Dr.
Huang, am I certain to have polycystic ovary syndrome? (I am 160 cm tall and my weight has been around 62-65 kg over the past couple of years, with no significant weight gain.) Is it true that I can only rely on medication to induce my period? Thank you, Doctor.

Ting, 20~29 year old female. Ask Date: 2017/05/22

Dr. Huang Yiwen reply Obstetrics and Gynecology

Hello Ms.
Ting: Based on the laboratory data, your condition appears to be polycystic ovary syndrome (PCOS), as your LH levels are significantly higher than your FSH levels (more than twice).
Additionally, your testosterone levels are also elevated.
You meet more than two criteria for the diagnosis of PCOS, such as chronic anovulation (due to your long-standing irregular menstrual cycles) and elevated male hormones.
Therefore, the diagnosis should not be an issue.
If you also exhibit symptoms of excess male hormones, such as hirsutism, acne, and hair loss, this further supports the diagnosis.
However, there is no specific effective treatment for polycystic ovary syndrome.
Given your current situation, I recommend taking cyclic progesterone for 10-14 days each month.
After completing the medication, your menstrual period should occur within a few days.
This long-term approach can help protect your endometrium and prevent the complications of endometrial hyperplasia.

Reply Date: 2017/05/22

More Info

Irregular menstrual cycles can be a frustrating and concerning issue for many women, and your experience highlights the complexities involved in diagnosing and managing conditions like Polycystic Ovary Syndrome (PCOS). Based on the information you've provided, it seems that you have been diagnosed with PCOS, which is a common hormonal disorder that can lead to irregular periods, among other symptoms.

Firstly, it’s important to understand that PCOS is characterized by a combination of symptoms, including irregular or absent menstrual periods, excess androgen levels (which can lead to symptoms like acne or excessive hair growth), and polycystic ovaries as seen on ultrasound. Your hormonal levels, particularly the elevated LH (Luteinizing Hormone) relative to FSH (Follicle Stimulating Hormone), support this diagnosis.
While medication is a common approach to managing irregular periods associated with PCOS, it is not the only solution. The use of hormonal medications, such as estrogen and progesterone, can help regulate your menstrual cycle and induce periods when they are absent. However, relying solely on medication may not address the underlying issues associated with PCOS, such as insulin resistance, weight management, and lifestyle factors.

Here are some additional strategies that may help manage your symptoms and improve your menstrual regularity:
1. Lifestyle Modifications: Weight management through a balanced diet and regular exercise can significantly impact the hormonal balance in women with PCOS. Even a modest weight loss of 5-10% of your body weight can help restore regular menstrual cycles and improve insulin sensitivity.

2. Dietary Changes: A diet low in refined carbohydrates and high in fiber can help manage insulin levels. Incorporating whole grains, lean proteins, healthy fats, and plenty of fruits and vegetables can be beneficial. Some women find that following a low-glycemic index diet helps regulate their cycles.

3. Regular Physical Activity: Engaging in regular exercise can help lower insulin levels and improve the body’s ability to use insulin. This can lead to more regular ovulation and menstrual cycles.

4. Monitoring and Managing Stress: Stress can exacerbate hormonal imbalances. Techniques such as yoga, meditation, or other relaxation strategies can be helpful in managing stress levels.

5. Alternative Therapies: Some women find relief through acupuncture or herbal supplements, although these should be approached with caution and ideally discussed with a healthcare provider.

6. Consultation with a Specialist: If you continue to experience irregular periods despite lifestyle changes and medication, it may be beneficial to consult with a reproductive endocrinologist or a gynecologist specializing in PCOS. They can provide a comprehensive evaluation and may suggest additional treatments, such as insulin-sensitizing medications like Metformin, which can help regulate menstrual cycles in women with PCOS.

In summary, while medication can be an effective way to manage irregular periods, it is not the only option. A holistic approach that includes lifestyle changes, dietary modifications, and stress management can be equally important in managing PCOS and restoring menstrual regularity. It’s essential to work closely with your healthcare provider to develop a personalized plan that addresses your specific needs and concerns.

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