Hormonal Imbalance: A Guide for Women with Irregular Periods

Q: Hormonal Imbalance: A Guide for Women with Irregular Periods

Please go to the outpatient clinic for a blood test.

Endocrine disorder

Hello Doctor: I haven't had my period for over a year (and I have not had sexual intercourse).
Previously, I had a blood test that showed low hormone levels, so the doctor prescribed me DIVINA (which contains white and blue tablets).
After taking a full cycle of 21 days, I did get my period, but I stopped taking it afterward because I felt nauseous every time I took the medication.
I have been afraid to take it again since then.
I previously tried to lose weight by eating less and increasing my exercise without using any diet pills.
My period has not returned since that time; I lost less than 5 kilograms, but I don't understand why this is happening.
During my high school years, my menstrual cycle was very regular.
Now, I am 172 cm tall and weigh 50 kg.
Whenever I eat too much or indulge in delicious food, I feel guilty, and I particularly love eating tapioca-based snacks, almost as if they are my main meals.
I know they are not nutritious, but if I don't eat them, I feel uncomfortable all over.
My meals mainly consist of vegetable soup (cabbage, onion, loofah, yellow bean sprouts, chives, enoki mushrooms, apples, guavas, etc.) along with unsweetened pearl green tea.
If I eat anything beyond these types of food, I panic about gaining weight.
I am also afraid of feeling hungry later, so I fill up on soup for lunch.
For dinner, I occasionally eat some fruit and a bit of meat.
If I have a late-night snack after class, I try to find a way to vomit it out because I have been haunted by my past weight issues.
Therefore, I exercise for at least 30 minutes every day.

In recent months, I have noticed that the hair on my hands has been growing unusually long.
I am afraid that if I take the medication prescribed by the doctor, I will gain weight, so I have been hesitant to go back.
I am worried and don't know what to do.
I wonder if I am over-exercising or if there is something wrong with my brain.
I have read a lot of information and suspect that my hypothalamus may not be functioning properly, or that there could be ovarian issues (I had an ultrasound last year, and the doctor said everything was fine).
Whenever I discuss this with my mother, she says I am too thin, but despite eating a lot, my period still does not come.
I want to get other tests done but don't know which department to visit.
I feel like others who are thinner than me do not experience this, so why is this happening to me? Is this a psychological issue or a physiological one? This has been troubling me for over a year, and I truly don't know what to do.
I have become very emotional, and even I can't stand it anymore >.< Please help me, thank you, Doctor.

Māomī, 20~29 year old female. Ask Date: 2005/03/02

Dr. Mao Yikun reply Obstetrics and Gynecology

Please go to the outpatient clinic for a blood test.

Reply Date: 2005/03/02

More Info

Understanding hormonal imbalance, particularly in women experiencing irregular periods, is crucial for managing health and well-being. Your situation, characterized by a year-long absence of menstruation, weight concerns, and emotional distress, suggests a complex interplay of physiological and psychological factors.

Firstly, it’s important to recognize that hormonal imbalances can stem from various causes, including stress, significant weight loss or gain, excessive exercise, and underlying medical conditions. In your case, the absence of menstruation (amenorrhea) could be linked to low hormone levels, which your doctor identified during your blood tests. The prescription of DIVINA, a hormone replacement therapy (HRT) containing estrogen and progestin, was likely aimed at restoring hormonal balance and inducing menstruation.

However, your experience of nausea and discomfort while taking the medication is not uncommon. Many women report side effects from HRT, which can deter them from continuing treatment. It’s essential to communicate these side effects to your healthcare provider, as they may be able to adjust your dosage or suggest alternative therapies that could be more tolerable for you.

Your dietary habits and exercise regimen also play a significant role in your hormonal health. While maintaining a healthy weight is important, excessive restriction of calories or food groups can lead to nutritional deficiencies that may exacerbate hormonal imbalances. It’s concerning that you feel guilt associated with eating and have resorted to purging behaviors. These patterns can contribute to a cycle of disordered eating, which can further disrupt your menstrual cycle and overall health.

The emotional toll you’re experiencing, including feelings of panic about weight gain and anxiety about your body image, suggests that psychological factors may also be at play. It’s not uncommon for women to experience heightened emotions during times of hormonal fluctuation, and the stress of trying to control your weight can lead to increased anxiety and mood swings. It may be beneficial to seek support from a mental health professional who specializes in eating disorders or body image issues. They can help you develop healthier coping strategies and address any underlying psychological concerns.

Regarding your concern about excessive hair growth (hirsutism), this can also be a symptom of hormonal imbalance, particularly related to elevated androgen levels. Conditions such as polycystic ovary syndrome (PCOS) can lead to irregular periods and hirsutism. Although your ultrasound last year showed no abnormalities, it might be worth discussing this symptom with your healthcare provider, as they may recommend further testing to evaluate your hormone levels more comprehensively.

In terms of managing your health moving forward, consider the following steps:
1. Consult a Specialist: If you haven’t already, consider seeing an endocrinologist or a reproductive health specialist. They can provide a more in-depth evaluation of your hormonal health and suggest appropriate treatments.

2. Nutrition and Eating Habits: Work with a registered dietitian who can help you develop a balanced eating plan that meets your nutritional needs without fostering guilt or anxiety. They can guide you in incorporating a variety of foods that support hormonal balance.

3. Mental Health Support: Engage with a therapist who can help you navigate your feelings about food, body image, and emotional well-being. Cognitive-behavioral therapy (CBT) has been shown to be effective for many individuals struggling with disordered eating patterns.

4. Physical Activity: While exercise is beneficial, ensure that your routine is balanced and not excessive. Incorporating relaxation techniques, such as yoga or meditation, can also help manage stress.

5. Regular Check-ups: Keep up with regular medical appointments to monitor your hormonal levels and overall health. Open communication with your healthcare provider about your symptoms and concerns is vital.

In conclusion, your situation is multifaceted, involving hormonal, nutritional, and psychological elements. By addressing each of these areas with the appropriate professionals, you can work towards restoring your menstrual cycle, improving your emotional health, and achieving a balanced lifestyle. Remember, you are not alone in this journey, and seeking help is a positive step towards better health.

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