08.28.2008  BY DR. KATE

Dr. Kate,

I am writing because unlike your recent column where the girl has been bleeding for six months, I have not had my period in almost as many. I have taken three pregnancy tests at three separate times throughout this duration, including one yesterday, so I know I am not pregnant. My periods have never been on the dot regular but this is the longest it has ever been. I have been on a diet for two months, am somewhat overweight and stressed at times and I know all those things can contribute, but can they make it last this long? I also have gotten off birth control about a year ago. My main dilemma is that I do not have health insurance and I am beginning to wonder if it is a big enough concern to actually spend the money out-of-pocket to visit a doctor. I was recently laid off so my health insurance went with the job as well as any cash flow which is why I am turning to you, I would like to know if you think, A) I should visit a doctor immediately, B) What could cause this long absence and is it normal? and C) Could it be just caused by the things I mentioned before--getting off birth control, diet change, stress, and being overweight? I am anxiously awaiting your answer since I am out of ideas.

Missing My Periods


Dear Missing,

When you don't have monthly periods--called amenorrhea--you're most likely not ovulating. And you certainly have a lot of things going on that can cause your ovaries to take a snooze. It's not unusual to see a delay in your periods right after stopping the pill, but if you stopped it a year ago, that's not likely what's happening here. Stress and diet changes can also delay your periods, but not for this long. Being overweight, though, can definitely throw off your cycles, by affecting the hormonal regulation in your body. If your periods were irregular before you were on birth control, you may be returning to the same disordered pattern.

A doctor can check you for three hormonal imbalances that lead to no periods: thyroid disease (over- or under-active), pituitary disease (generally a benign cyst) and polycystic ovarian syndrome. Once you've gone five or six months with no periods, I do think it's important that you see a provider--even with the out-of-pocket cost. Going too long without periods not only means that you may have a hormonal problem that needs to get treated, but over the long term you have a higher risk of uterine cancer. So check out your local health clinics, particularly Planned Parenthood, that offer "sliding scale" visits, where they charge you what you can afford. I know it may be expensive, but your health is worth it.

Have any of you lost your periods (without birth control)?



6 Comments

said:

When I was 13, I went for nine months without a period - and ended up with an ovarian tumor. Even without insurance, it is certainly something to check out!

Jane said:

I'm about 4 months after going off the pill, and my period just disappeared this month. I also have more pimples than a 12-year old boy (I've always had some acne, but not this much). The only explanation I see is that my hormones are only just getting out of whack now?

Megan said:

Thank you thank you for mentioning Polycystic Ovarian Syndrome. It's not on most doctors' lists to test for (even though its fairly common AND runs in families), but luckily my Dr thought to check for it and figured out that's what was making me miserable. PCOS is a collection of symptoms, and doesn't necessarily mean you have cysts on your ovaries (I haven't had scans but its likely I don't have them).

The classic symptoms of PCOS include an irregular period, which I would say *usually* means an infrequent period, but in my case it was that every month I'd have my period for about 10 days! Ugh, that's way too long. I follow the rest of the symptoms pretty well, which include weight gain, acne, and some darker, thicker hair growth on my face (ick). I am on the Pill (Yaz) which has helped a lot, as well as a medicine called Metformin which by itself halted my weight gain and allowed me to start losing weight. I see an endocrinologist, which I've heard are the best doctors to deal with it. Luckily my gyno is good about it too.

So to the person who asked the question, I would say that if its making you miserable, you might want to get it checked out. Jane, you might want to as well.

angel said:

i just want to know is duching a good thing to do or a bad thing to do? i have been to the doctor and found out that douching was not good but im not sure how does my body clean it self after sex or just to wash away a funny smell. also i sometimes get a funny fishy oder only when during sex, but i never have this oder before hand. and everytime i go to get it check out its always bv. so r some women pron to getting bv or is it just me?

said:

I worked nights occasionally and everytime I did, I would miss a couple months of my period. Also, I would miss periods during especially stressful times. I have also been overweight most of my adult life.

Dr. Kate said:

Angel, some women are prone to getting BV - and if you get frequent BV infections, talk to your gyno about preventive treatment. But don't douche - it won't fix BV, and you risk getting PID. Your vagina will clean herself out after sex.

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Em & Lo, more formally known as Emma Taylor and Lorelei Sharkey, are the self-proclaimed Emily Posts of the modern bedroom.

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City.

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