Hello XXXXXXX

Thanks for writing to us. I explain your presenting condition in simple manner.

According to your clinical features, you are mostly suffering from secondary amenorrhea (absence of period after initiation). Most common cause among sexually active women is pregnancy. It is possibly ruled out by several home pregnancy test & blood test (as described).

In this context, other reasons are hormonal imbalance caused by disturbance of Hypothalamus-pituitary-ovarian (HPO) axis, hypothyroidism state, over weight, PCOS (Poly Cystic Ovarian Syndrome) or ovarian cyst, taking any psychiatric medication, irregular diet habit or anorexia, uterine pathology or pelvic infection, high prolactin level etc.

Here, you need to undergo some investigations under the guidance of your gynecologist to identify the possible causes. You would need a complete health check up along with pelvic ultrasound scan, thyroid profile, LH/ FSH ratio, blood sugar (PPBS) test, prolactin & blood testosterone level to pin point the diagnosis.

In addition, some fertility test may be required if you are trying to conceive for more than one yr. It includes husband semen analysis, test for tubal patency & ovarian reserve, serial follicular study for proper ovulation, D-21 progesterone assay & endometrial tissue biopsy etc.

Complete treatment depends on underlying etiology. You may require hormonal medication along with other supportive treatment to bring your period back. You can take some pain killer or anti-spasmodic medication along with H2 blocker to reduce pelvic pain temporarily. Local hot compression is also useful.

In the interim, do the following things:

1) Take healthy low carbohydrate diet with more vegetables. Avoid all junk/ fast/ spicy food stuffs.
2) Keep your bowel habit regular and maintain personal hygiene properly.
3) Do regular physical exercise to control body weight and it has key role to regularize period & improve fertility .
4) Try to avoid stress by yoga or meditation or deep breathing exercise (15-20 minutes) regularly.
5) Iron & folic acid supplements are also needed. Drink plenty of water/ fluid and always take sound sleep.
6) Wear loose fitting breast support and avoid too much handling of breast.

Hope, I have answered your query. Let me know if you need clarifications.

Wish your good health & take care yourself.

Regards,
Dr Soumen.

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Hello XXXXXXX

Thanks for follow up query.

Above said condition along with other associated factors (which I have mentioned in my previous reply) may cause hormonal imbalance or anovulation.

Controlled body weight is a positive thing for you and continue light to moderate exercise regularly.

In this circumstance, I strongly urge you to consult with your gynecologist and undergo relevant investigations as mentioned above. They will help us to isolate the cause and plan its treatment. He/she might also prescribe a few hormonal medication to treat the present condition.

Maintain a healthy life style with suggestive measures as described previously.

Hope, it helps for your information. If you do not need any clarification, you can close the discussion.

Regards,
Dr Soumen

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