I've had irregular periods since august-I haven't had one since 7-8 weeks agoand I've got this ache

Hello, Welcome to the AMD forum of doctors. I can understand your concern for the absence of your menstrual periods. Two most important possibilities for such symptoms are pregnancy and post pill amenorrhea. Post pill amenorrhea is defined as lack of menstrual periods for at least 6 months after stopping birth control pills. The cause is suppression of the pituitary gland by the birth control pills which prevents ovulation and hence irregular or absent menstrual cycles. To rule them out you need to do a urine for pregnancy test and get serum HCG levels and ultrasound uterus done. Ultrasound uterus will rule out both. Blood tests showing a low level of FSH, LH and estrogen are also sufficient to confirm the diagnosis of post pill amenorrhea. If both of them are ruled out, then other causes need to be probed. These are stress and anxiety, malnutrition, depression, overexercising, sudden weight loss or gain (obesity), thyroid disorders and hormonal imbalance due to polycystic ovarian syndrome(PCOS).Smoking is also associated with secondary amenorrhea. Sometimes tumors of the ovaries and brain may also cause absence of menstruation. Of all these causes, polycystic ovarian disease can cause such lower abdominal pains that you are having. Some of these causes are modifiable like if you are having stress then yoga and meditation and antianxiety medicines can help you out. Eat regular healthy, nutritious food and indulge in moderate exercises. If still you do not get any periods, then consultation from a gynecologist is desirable to rule out all these medical conditions. Investigations include hormonal studies, thyroid hormone levels, ultrasound uterus and MRI head. I hope it helps. Take care and please do keep me posted in case you have any additional doubts. You can find more relevant information about this from the following site: http://www.medicinenet.com/amenorrhea/article.htm

Comments:

Dr.Kokil Mathur

Tue 17, Nov 2009 08:58pm

Hi! Your situation has been appropriately assessed and explained by Dr Bhupinder. She has also enumerated the various possibilities and tests you could take to reach a diagnosis. You have ample material to discuss with your gynecologist now. Set up an appointment with a gynecologist. Take a pregnancy test because after stopping the pill if you have an active sexual life and unprotected sex, then pregnancy is the first thing to be ruled out. If the test is negative, then all the other conditions mentioned by Dr Bhupinder will have to be ruled out one by one. Please discuss this with your doctor. Do let me know if there is any thing else and keep me posted. Take care!