Irregular periods and ovulation

Q: I’m 23, and after seven years of irregular periods, now I am not ovulating at all. My doctor seems to think my weight is the problem. Although I am not within a normal weight range for height, I have a feeling it is more than that. Do you have any suggestions?

A: You are in good company: Many women share your problem of irregular periods. The problem you are describing sounds like polycystic ovarian syndrome, a reasonably common problem, although there certainly are other causes of irregular periods. If your thyroid hormone levels are off, or if your pituitary gland is making too much of a hormone called prolactin, you can have very irregular periods. These are easy to check by doing blood tests for prolactin levels and thyroid hormone levels. (Make sure your doctor orders a TSH test – the most sensitive thyroid test – as well.) Daily medication easily solves both of these problems.

If your thyroid and prolactin levels are normal, your ovaries are probably not ovulating well because they are in a constant state of overdrive. You implied that your weight is up, and weight reduction will certainly help this problem. If you are trying to get pregnant, you do need to ovulate, and a medication called clomid will usually help. However, if you are not trying to get pregnant, there is no medical need whatsoever to ovulate.

It is a good idea to have a period, however, at least every two to three months. Provera is a synthetic progesterone that tricks your uterus into thinking you have ovulated (we make progesterone when we ovulate) and leads to a clean-out bleed. You would also most likely be helped by birth control pills, which also contain progesterone. They will also produce periods.

One other advantage to taking birth control pills is that if you are also having a problem with increased hair, the pill will help keep that under control. If your ovaries are in a constant overdrive state, they are also making increased amounts of testosterone, which leads to the hair growth. The pill suppresses ovarian function in all ways.

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