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Amenorrhea (No Period)

Answered on August 19, 2014
Created April 10, 2013 at 2:28 AM

Hi

At the end of 2011 I lost my period. I suddenly started to feel very bloated, sick and tired and they diagnosed me with Celiac Disease. Beside being on a complete gluten free diet my period did not return.

I was told I have hypothalamic amenorrhea, PCOS etc. I have been feeling very cold lately, dry skin, acne and I've gained 7 kgs beside regular exercise and paleo diet!

Few months ago I went to an integrative doctor that diagnosed me with hypothyroidism beside my blood results being in the "normal" range. However, my period did not return, my estrogen is still low, I stopped exercise and my period did not come back!

Last year when they gave me metformin I had a period for the first 2 months on it but that was it!

Anyone have any similar experience and got it all sorted?

618fc5298c4a96b817c4918c795a875f

(1217)

on May 08, 2013
at 07:38 PM

What is your weight and what do you eat in an average day? Have you ever suffered from any kind of disordered eating - anorexia, bulimia, overeating? What kind of blood tests were given to you that indicated hypothyroidism even though your blood was "normal"? Can you possibly show us the numbers?

3491e51730101b18724dc57c86601173

(8395)

on April 11, 2013
at 07:50 AM

Please see my answer--it was too long for a comment

3491e51730101b18724dc57c86601173

(8395)

on April 10, 2013
at 05:54 PM

Please see my lengthy comment/answer

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3 Answers

1
39311794c054f89a226f33e1afd08721

on May 08, 2013
at 07:41 PM

My experience with losing my period and not being an unhealthy weight or losing weight was that I was exercising 5-8 hours a day training intensely for the Olympic team trials and eating like mad to maintain my weight.

The calipers said 20-23% body fat so it definitely wasn't that. It was the exercise and I know it was that and nothing else because it was only at the peak of training that it would happen.

I felt cold at times to myself, I felt like a furnace to other people.

How much are you exercising?

1
3491e51730101b18724dc57c86601173

(8395)

on April 10, 2013
at 05:54 PM

Interesting discussion Dr. Jick. Stephanie Ruper, who is not a doctor, claims in her ebook "PCOS Unlocked" that women with HA CAN develop cystic ovaries and therefore have both HA and PCOS.

Personally, I don't think she's correct. I think that the idea that cystic ovaries equal PCOS is a fallacy because my understanding is that cystic ovaries, in an of themselves, are NOT the diagnostic criteria for PCOS. My understanding is that a great many women without PCOS have cystic appearing ovaries on US exam, and about 50% of women with a diagnosis of PCOS (based on clinical symptoms and hormone ratios) don't have cystic appearing ovaries.

Ruper posits that obesity causes testosterone levels to increase, and that causes PCOS. When a thin woman develops PCOS symptoms, she believes it is because all the hormones are disrupted (as you stated) by stress or starvation (often due to ED's, but celiac could certainly be a cause), estrogen more than testosterone. That again causes testosterone dominance, and she believes this explains PCOS in women with HA.

My own experience belies her theory that obesity causes the most common type of PCOS. I think it's the other way around--PCOS causes obesity. I was always low to normal body weight, but had PCOS symptoms even before menarche (as does my 12 year old daughter who is exactly 50th percentile BMI, has a classic LH/FSH ratio indicating PCOS) including severe acne, reactive hypoglycemia, and once menses began, highly irregular, painful, heavy periods. I did not ovulate without fertility drugs. I did not put on weight until I started fertility treatments in my 30's and went on to IVF to conceive my first child (20+ years ago, the metabolic connection to PCOS was not understood). 8 years later I learned about the metabolic connection--on a low carb diet and Metformin I started regular menses immediately and conceived within 6 months (thrilled, but wasn't even trying to conceive). Obesity did NOT cause my PCOS, nor did HA. The cause was definitely metabolic--insulin resistance, though.

Ja has had a huge insult to her metabolism, thyroid issues, and it will be interesting to know if her diet is high in carbohydrates and whether it contains sufficient healthy fats. It sounds as if she has gained weight and is now of normal body weight.

I'm curious about the medical approach of putting people on the Pill to mask PCOS symptoms until one wants to try to conceive. Wouldn't it be a better strategy to treat the underlying cause and correct the metabolic issues through a therapeutic diet (and Metformin in some cases) to both preserve fertility and prevent downstream metabolic and cardiovascular sequelae of insulin resistance? The Pill itself can contribute to weight gain and cardiovascular issues. Why is the Pill considered a first approach to treatment (asking because it's only a matter of time before it is suggested for my daughter)?

1
6887092da9aacfdf392bcaf1bc499a71

on April 10, 2013
at 05:11 AM

I am an ob/gyn, 25 yrs. You cannot have PCOS and HA at the same time! They are the opposite. HA is complete hormonal shutdown. Seen in very low body fat women, anorexia, marathon runners and other big time athletes. HA can come and go. PCOS is an illness that starts as a teenager. It is a hormone imbalance and we do not know the cause. There is insulin resistance, increased estrogen, lack of ovulation, and sometimes male hormone issues such as hair growth, acne. Both conditions can be treated using the Pill, and this is fine until you want to get pregnant. Then, you really need a bunch of hormone blood tests to figure out what is wrong. PCOS can respond to Paleo, low-carb. HA can respond to weight gain and increasing body fat above 15% (around there, not sure of the exact %).

Bryan Jick, MD, FACOG www.fowh.com

3491e51730101b18724dc57c86601173

(8395)

on April 11, 2013
at 07:50 AM

Please see my answer--it was too long for a comment

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