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Can severe ACNE and hair growth in chin be HORMONAL?

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Recently I've had abnormal and severe acne and hair growth from my chin. I've always suffered from mild depression but it's gotten worse with a lot more mood swings. My period is 8 days late which has NEVER happened before. I have a heavy feeling a slight pain in my right ovary. I'm on lamotrigine 50mg, Wellbutrin 300 MG, and I use topical tretinoin for my acne (which isn't working). I recently was tested for hypothyroidism but apparently my levels are normal. I suspect something hormonal.

Category: Endocrinologist

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Category: Diabetologist
 27 Doctors Online

Hello.
Thank you for your query at DoctorSpring.com.
I understand your concern.
As you suspect, your acne and excess facial hair (mild hirsutism) are most likely due to hormonal imbalance, possibly excess androgens. You need further evaluation for this.
A common cause of irregular cycles and hirsutism is PolyCystic Ovarian Syndrome (PCOS) which affects young females. Obesity is a risk factor for this. This is a benign condition which responds well to treatment.
In your case, if you have been sexually active, then you first need to rule out pregnancy. You can do this by taking a urine pregnancy test now, because it has already been a week since your expected period.
If it is negative, wait for another week for menstruation to occur. If after a week, you still do not get a period, then you can take a course of Medroxyprogesterone 10mg tablets, twice a day for 5 days. After stopping this course, menstruation will occur.
Once you get your period, you need to test levels of Serum Testosterone, Prolactin, LH and FSH on day 2 of your next cycle.
You also need to get an ultrasound of the pelvis to have a look at the ovaries.
You can get these tests done and upload the results for further management. Alternatively you can consult a gynaecologist for the same.
Let me know if I can assist you any further.
Thank you.


Patient replied :

Just to let you know, I am a little overweight but I haven't gained any weight recently, if anything I've lost some. I exercise regularly and eat pretty well.
I do have a couple questions. Could the delayed period be caused by the Lamictal drug? My psychiatrist didn't mention it as a possibility but I've read a few cases of it online.
Also, if I do have PCOS, what is the common treatment?


Hello.
Delayed periods can be due to Lamictal, especially if you have only recently started it. Changes due to the drugs, stress, etc may also lead to a delayed period. Since you also have features of excess androgens, we need to evaluate for these causes such as PCOS.
An estrogen-progestin contraceptive as first-line pharmacologic therapy for most women with PCOS.
I hope this answers your questions.
Let me know if you have additional queries.
Thank you.


Dr. J Muthukrishnan
Category: Diabetologist
Experience: 
Fellowships/Training: 
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
Dr. J Muthukrishnan and 4 other Medical Specialists are ready to help you

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