Irregular periods require investigation

Dr. Gott — Wed, 13 Oct 2010 05:01:22 +0000

DEAR DR. GOTT: My daughter is 19 and has always had irregular periods (every other month or longer). Her last period was in February. She is not sexually active, and a gynecological exam was normal. The doctor prescribed Provera and wanted to start her on a regimen of birth-control pills. She has a history of migraines and is reluctant to try this treatment. What are her options? She had a lifestyle change living away at college last year but did not have a weight change. Many times, she will have PMS but won’t have her cycle. Should we get another exam that includes a thyroid check or anything other than a routine gynecological exam?

DEAR READER: Adolescent girls don’t always have regular periods, especially during the first few years, but as they age, they should experience a gradual change to regularity. By 19, your daughter should be having regular menstrual cycles. Average cycles occur every 28 days. Young teens can cycle every 21 to 45 days, and adults from 21 to 35 days. If she is not, further examination and testing should be performed.

I recommend your daughter request that the situation be looked into further with blood tests to check various hormone levels to check for a thyroid condition, polycystic ovary syndrome (PCOS), low estrogen or progestin levels and perhaps an ultrasound to check for physical abnormalities such as deformity or cysts.
Birth-control pills are often prescribed in order to regulate hormone levels, which can then regulate cycles in those whose hormones fluctuate or are consistently low. Unless an underlying cause of your daughter’s lack of menstruation can be found, this may be an option to consider.

Tell your daughter to insist on further testing to get to the bottom of the situation.

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Irregular periods require investigation