WOMENS-HEALTH Messages for March, 1997: Re: lack of periods

Re: lack of periods

From: Richard M. Chudacoff, MD (anonymous@obgyn.net)
Fri, 14 Mar 1997 15:45:53 -0600 (CST)

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In reply to: Joyce: "lack of periods"

At Thu, 13 Mar 1997, Joyce wrote: >
>I am concerned and confused and am looking for input. I have always had
>regular periods all my life, you could set a calendar by it. I just
>turned 38 in January. Last June (1996) was my last "official" period. I
>say "official" because my doctor had put me on pills to start my period
>for three months (which it did) with the hopes that my periods would
>restart by itself in February, but no such luck. He then did a
>menopause test, and discovered that I am not on menopause. He then
>informed me that I should not worry as it is not uncommon for some women
>to only experience 3 or 4 periods a year and if I do not have one by
>July to August, to let him know. I have not had any symptoms of having
>a period other than when I was on the pills, and I know that I am not
>pregnant.
>
>Since then I have had several people ask if my doctor performed an
>ultrasound to check for tumors or cysts, which he did not. I have had
>other people suggest that I get a second opinion.
>
>I guess my question is, should I get a second opinion, or should I just
>take what my doctor said and not worry? Or if anyone should have any
>other suggestions, please feel free.
>
>Any input is greatly appreciated.

Anytime you feel uncomfortable with a decision your doctor makes you should consider getting a second opinion, simply to alleviate you concerns.

It is not unusual to become oligo-ovulatory as you mature. This simply means that you are not producing an egg every month. It makes sense that as you get older it may be harder to stimulate an egg to ovulate. The eggs that have preceded these were easier to recruit. Now your eggs are a little more stubborn.

There are syndromes where women have chronic annovulation, where they do not ovulate at all, or rarely, and these women tend to produce cysts. These women tend to be heavy, with oily skin or acne, and have increased facial, chest and abdomenal hair.Your case does not sound like this, but then I do not have the benefit of examining or even seeing you.

If your physician examined you and felt that the exam was normal, especially if the physician is well known to you and has examined you numerous times in the past, then you may not need an ultrasound. If you are thin, and not uncomfortable with a GYN exam, then your doctor's exam may even be more accurate than an ultrasound, which can confuse loops of bowel with adnexal/ovarian cysts.

If you are a non-smoker and have no other risk factors/ contraindications for OCPs, then birth control pills may be an option to give you a regular withdrawal bleed each month. Your doctor is correct that if you menstruate regularly every three or four months the risk of endometrial hyperplasia is low. In that case you could have an induced withdrawal bleed every three months as an alternate form of therapy. This also depends on your conception/contraception plans.

It would be a good idea to express your confusion or anxiety with your doctor, who will be able to explain all this to you in depth.

-- Richard Chudacoff, MD Baylor College of Medicine BaylorMedCare Houston/Richmond, TX

*Note: Opinions expressed here are for educational purpose only. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options.

Next message: cheryl: "Help: serious medical problems after trauma of stillbirth -- Lupus?"
Previous message: Zhongshuang: "Take Clomiphene after being pregnant"
In reply to: Joyce: "lack of periods"

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