|For the week of: September 25, 2000|
Question: I am a 28 years of age and didn't start my period until I was 20. It has been one year since I have had a period. Is this normal? If not, do you have any thoughts on the most likely cause of this?
Answer: It is not normal to go without a period for a year, unless you are pregnant, or have gone through the menopause. The absence of periods is called amenorrhea, and can be caused by many factors. If a patient is not pregnant, the period may stop due to problems with ovulation or hormone imbalance. Some women produce either too much estrogen or not enough, and the result can be a stoppage of her menstrual cycles.
Thyroid dysfunction and secretion of too much of a hormone called prolactin, (which is made in the pituitary gland) can also stop the periods. Extreme weight change, either gains or losses, can also cause amenorrhea. Extreme strenuous exercise, like that seen with gymnasts or marathon runners can lead to hypothalamic hormone imbalance and lack of estrogen.
The bottom line is you should have a workup consisting of thyroid testing, measurement of prolactin, follicle stimulating hormone, luteinizing hormone, androgen levels if there is any history of excess hair growth on face or abdomen. If there is a hormone imbalance, then pregnancy might be able to be achieved by medicines designed to stimulate ovulation. If your doctor is unwilling to do testing, you may want to get a second opinion.
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