Irregular Menstruation: Causes and Concerns for Women - Obstetrics and Gynecology

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Irregular menstruation can be a source of significant concern for many women, particularly when it has persisted for an extended period, as in your case. Understanding the underlying causes of irregular menstrual cycles is crucial for addressing potential health issues and planning for future fertility.

From your description, it appears that you have experienced irregular menstrual cycles since the onset of menstruation, with an average of only 8-9 periods per year. This is indicative of oligomenorrhea, which is defined as infrequent menstrual periods. The variability in your cycle length, ranging from 30 days to as long as 5-6 months, further complicates the situation.
Your medical history is particularly relevant. The discovery of ovarian tumors, specifically a mature teratoma, and subsequent surgery may have impacted your hormonal balance and menstrual regularity. Although your follow-up ultrasounds have shown no abnormalities, the hormonal fluctuations that can occur after such surgeries may still be affecting your menstrual cycle. Hormonal imbalances, particularly involving estrogen, progesterone, and androgens, can lead to irregular cycles.
The hormonal blood tests you provided show that your levels of FSH (Follicle Stimulating Hormone), LH (Luteinizing Hormone), and testosterone are within normal ranges, but your prolactin level is elevated. Elevated prolactin can lead to menstrual irregularities and is often associated with conditions such as prolactinoma or hypothyroidism. Your TSH level is within normal limits, which suggests that your thyroid function is likely not the cause of your irregular cycles.

The concern about future fertility is valid, especially considering your age and the history of ovarian tumors. While your doctor may suggest waiting until you are ready to conceive to address these issues, it is important to advocate for your health. Irregular cycles can sometimes indicate underlying conditions such as polycystic ovary syndrome (PCOS), endometriosis, or other hormonal disorders that could impact fertility.
In terms of management, lifestyle factors such as stress, diet, and exercise can significantly influence menstrual regularity. High stress levels can lead to hormonal imbalances, so finding ways to manage stress through relaxation techniques, exercise, or counseling may be beneficial. Additionally, maintaining a healthy weight is crucial, as both obesity and being underweight can affect menstrual cycles.

Regarding your interest in traditional Chinese medicine (TCM) and herbal remedies, it is essential to approach these with caution. While some women find relief from symptoms through TCM, the efficacy of such treatments can vary widely. If you choose to explore this route, consider consulting a qualified practitioner who can provide a tailored approach based on your specific symptoms and medical history.

In conclusion, while your current healthcare provider may suggest waiting to address these issues until you are ready to conceive, it is essential to continue advocating for your health. Seeking a second opinion from a reproductive endocrinologist or a specialist in menstrual disorders may provide you with more insight into your condition and potential treatment options. Regular monitoring and a proactive approach to managing your menstrual health can help alleviate your concerns about future fertility and overall well-being.