OB-GYN (Obstetrician-Gynecologist) Questions

“No menses”

Hi,

I am a 23 year old obese (around 280+) woman with PCOS. I've had this for several years. My first cycle was at 13 years of age, but it was abnormally heavy and lasted for 2-3 weeks. It became a pattern of heavy menstruation for 2-3 weeks around every two to three months, then it was around every six months before ceasing entirely. At 16 I was diagnosed with PCOS and from there out was given oral birth control to manage it. And since I was already on metformin as well to manage diabetes the medicine help to make my cycles almost regular.

But now I haven't had a cycle in two months. I've been off metformin for a bit, maybe about three or so months but started again recently. I had and still take the oral birth control though and have light spotting what can I do to keep my cycles regular?

Female | 23 years old
Complaint duration: Two Months
Medications: Metformin 500mg, Tri-Sprintec 28 day, Levothyroxine 0.100mg, Victoza 1.8mg, Citalopram 10mg
Conditions: Type 2 diabetes, PCOS, Hypothyroidism, Sleep apnea, obesity

4 Answers

PCOS is a hormone in balance and can be influenced by the weight of the individual. Patient diet and exercise in balance are recommended as the first line.MetForman may be helpful. And for some patients may normalize menses and improve chances of fertility.Hypothyroidism can also influence the menstrual cycle and although thyroid replacement if the TSH has not been checked recently, it may be time to do so for many patients.A pelvic ultrasound and if sexually active a pregnancy test may be indicated.
Birth control pills could cause you to have no period. As long as you are still taking them, helps with the excess estrogen PCOS causes. Discuss this further with your OBGyn.
Take care and stay safe!
Weight loss is crucial - at your age being over 250lbs and already burdened by Diabetes is a serious thing - find a doctor that can help you loose weight rather than prescribe you more medications. Consider bariatric surgery if no success working with a holistic functional medicine doctor. Ask your doctors about adding T3 and less T4 (Levothyroxine), also address why you need escitalopram as it can promote or worsen weight gain. You are very young and deserve to live a beautiful healthy life free of medications. Focus on your weight: consider a food sensitivity test, checking your adrenal hormones, checking and addressing your gut health barrier, start some supervised intermittent fasting and an adequate supervised fitness program. Best of luck!
Well, it sounds like you’ve got some excellent doctors who are caring for you appropriately.
So if the treatment of your POC, T2DM and hypothyroidism is well treated, then all that’s left to you is to lose weight. Easier said than done, I’m aware, but it’s probably the most important part for you to consider.