Hello,
Thanks for writing to DoctorSpring.com with your health concern. I would need more information to help you best.
Do you always have regular cycles ?
Has this ever happened in the past ?
Please do let me know, and I would guide you further.
Take care.
Look forward to hearing from you.
Patient replied :
My periods are usually regular.
About a year ago it was late but it did come 2 weeks later and was back on schedule from the on. I have NEVER, had that happen where my period has been this late and having cramping on and off that long! Usually when I have cramping my period follows along 1-3 days later.
Thank you !
Hello.
If pregnancy is reasonably ruled out, see a Specialist.
I think there are a few factors clearly responsible for this irregularity and delay in cycles.
One is the weight issue, second is the insomnia.
Stress, weight gain, late nights, erratic eating, travelling, smoking , drinking -- all can delay cycles.
You should have an internal exam, Pap smear, pelvic sonogram, hormones ( FSH, LH, TSH, Prolactin, OGTT, DHEAS, Free Testosterone , Lipid Profile ).
THis would rule out PCOS - polycystic ovarian disease, which is the most likely diagnosis in your case.
Also, it would rule out potential causes like hypothryoidism etc.
Take care.If pregnancy is reasonably ruled out, see a Specialist.
I think there are a few factors clearly responsible for this irregularity and delay in cycles.
One is the weight issue, second is the insomnia.
Stress, weight gain, late nights, erratic eating, travelling, smoking , drinking -- all can delay cycles.
You should have an internal exam, Pap smear, pelvic sonogram, hormones ( FSH, LH, TSH, Prolactin, OGTT, DHEAS, Free Testosterone , Lipid Profile ).
THis would rule out PCOS - polycystic ovarian disease, which is the most likely diagnosis in your case.
Also, it would rule out potential causes like hypothryoidism etc.
Take care.
Patient replied :
Oh wow, OK! I will make an appointment with an OB/GYN.
Thanks yo so much for your input!
Hello.
Please do that.
The hormonal levels will also clear your doubt regarding peri-menopause, which frankly, I don't think is likely at 33. Unless there is a family history of very early menopause.
Please feel free to revert once you have undergone the workup.
Wish you good health always.
Take care.
Patient replied :
Hello good evening,
I went to my PCM on Tuesday since I don't have a GYN (and would need her to put in a consult to there)
So she did a bunch of lab: (not alot of what you suggested :(
9/10/2014
Prolactin level : 11.4 ng/ml
Follicle Stimulating Hormone 6 mIntL_unit/ml
(Luteal Phase 1.5 – 9.1)
TSH 2.16 mcIntl_unit/ml
T4 0.95 ng/dL
Glucose level 107 mg/dL
Vitamin D 25-hydroxy normal
Diff (C) normal
CBC w Diff normal
Mean cell hemoglobin (low- 31.7 g.dL) normal
Comprehensive Metabolic Panel normal
She stated if I didn't get my period next month then she would have an ultrasound done and give me a consult to GYN.
I'm not cramping or anything anymore, so I guess my body is done with trying to have a period. What is your opinion on the entire thing?
Thank you for your time!
Hello.
The workup is incomplete.
Get the complete list done, and insist on a gynecological evaluation and pelvic scan.
That is essential. I have mentioned the tests that needs to be done in my earlier reply.
Take care.