Brief Answer:
LOSE WEIGHT - PCOD LIKELY.
Detailed Answer:
Hello XXXXXXX
Thanks for writing to us with your health concern.
Well, since pregnancy is conclusively ruled out, I can think of the following possibilities -
1. Obesity itself can cause menstrual irregularities.
2. Some kind of stress, anxiety, travelling, change in climate or sleeping patterns.
3.
Polycystic ovarian disease - extremely common in
overweight women . It is underlined by basic hormonal imbalance, due to which there are multiple very small follicles ( cysts ) in the ovaries, leading to difficulties in ovulation and
irregular menstruation.
In my practice, for a patient like you, I would conduct a thorough per vaginum and per speculum examination as well as recommend a pelvic ultrasound scan to detect
polycystic ovaries.
In addition to the blood tests you mentioned , the following would be necessary -
FSH
LH
Prolactin
Glucose tolerance test
Fasting serum insulin
Serum free testosterone
DHEAS.
These would be sufficient to establish a diagnosis of polycystic ovarian disease if it exists.
The mainstay of treatment would be
weight loss - even a 5 % weight loss would regulate cycles.
In addition, Metformin is a drug commonly prescribed to help you along.
The
fungal infection would mostly be caused by rubbing together of the inner surfaces of the thighs due to being overweight.
You can use
topical antifungal ointments like Candiderm ointment.
Try losing weight as it will help in ameliorating such infections.
Avoid keeping the area wet or damp, local Neosporin powder will work.
Wear non allergic organic undergarments or plain cotton or linen.
Avoid rubbing, itching or handling the area.
Do not use medicated or perfumed soaps , cleansers, douches, tampons, toilet paper etc.
All the best.
Please feel free to ask for further clarifications.