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Never Had A Period

Question

I am 23 and up until about two months ago I had never had a period. I started seeing an endocrinologist/fertility specialist last September. He first found that my estrogen level was about 60 so he put me on Demulin 135.  After taking the pill for September and October I still did not see a cycle, then he switched me to Demulin 150. I took it for a month and I still did not see anything. I called my doctor and he switched me to an estrogen therapy. As soon as he switched me to the estrogen therapy I saw some spotting for three days. I had been on the therapy for about 4.5 months before I saw any more spotting.  By then I had asked my doctor if we could try the Demulin 150 again because my husband and I were becoming very frustrated. I took the cycle of Demulin for April and I saw some more spotting for three days on the 26 of April and again on the 26 of May. My question is will my periods be just spotting or will it eventually turn into a real cycle. Our goal is to conceive a child and I know that taking the birthcontrol pill is defeating this purpose. What is the next step you think we should take in order to make conception possible?

Answer

Last Updated: June 9, 2013
If you have never had a spontaneous period at the age of 23, you need a comprehensive workup including chromosomes, ultrasound or CAT scan, and blood tests to test your thyroid, pituitary hormones, and ovarian hormones. You need a diagnostic studies to see if you have an anatomical problem with your uterus or ovaries; an inherited congenital problem; a more ordinary hormonal problem such as polycystic ovarian syndrome, stress or exercise related problem; or a rare hormonal problem. The spotting you had after birth control pills was not a period; it is artificial bleeding and all it does is prove that you have a uterus. I believe that at your age, you are more likely to have a somewhat rare problem. Some of these problems can only be diagnosed properly in a University setting, where hormones extracted from the hypothalamus are used to diagnose pituitary problems by stimulating the pituitary gland. I would encourage you to seek your evaluation at a University medical center in the gynecologic endocrinology department. You will get the quickest, most definitive answer to your questions if you are a patient in this type of setting. You cannot treat your problem without knowing the cause of the lack of periods.

Dr. Mary Davenport

Answered By:

Mary Davenport, MD, MS
Mary Davenport, MD, FACOG, an obstetrician/gynecologist from the Oakland Region of California, offers telehealth services over MyCatholicDoctor.com She graduated from Tufts University School of Medicine and completed her residency at UC San Diego. Dr. Davenport is a Fellow of the American College of Obstetrics and Gynecology, and serves on the Advisory Board of the California Association of Natural Family Planning.

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