Dr. Gott: Irregular periods require further investigation

DEAR DR. GOTT: My daughter is 19 and has always had irregular periods (every other month or longer). Her last period was in February. She is not sexually active, and a gynecological exam was normal. The doctor prescribed Provera and wanted to start her on a regimen of birth-control pills. She has a history of migraines and is reluctant to try this treatment. What are her options? She had a lifestyle change living away at college last year but did not have a weight change. Many times, she will have PMS but won’t have her cycle. Should we get another exam that includes a thyroid check or anything other than a routine gynecological exam?

DEAR READER: Adolescent girls don’t always have regular periods, especially during the first few years, but as they age, they should experience a gradual change to regularity. By 19, your daughter should be having regular menstrual cycles. Average cycles occur every 28 days. Young teens can cycle every 21 to 45 days, and adults from 21 to 35 days. If she is not, further examination and testing should be performed.

I recommend your daughter request that the situation be looked into further with blood tests to check various hormone levels to check for a thyroid condition, polycystic ovary syndrome (PCOS), low estrogen or progestin levels and perhaps an ultrasound to check for physical abnormalities such as deformity or cysts.

Birth-control pills are often prescribed in order to regulate hormone levels, which can then regulate cycles in those whose hormones fluctuate or are consistently low. Unless an underlying cause of your daughter’s lack of menstruation can be found, this may be an option to consider.

Tell your daughter to insist on further testing to get to the bottom of the situation.

DEAR DR. GOTT: I am a 72-year-old woman who has lived with a weight problem since puberty. My husband and I have been on the no-flour, no-sugar diet for the past 10 weeks. Although the weight loss is slow, there are some things I have learned about myself. First, after years of yo-yoing on Weight Watchers, including being a lecturer for them, I never learned how to keep it off. Secondly, I discovered that I have an addiction to flour and sugar products. I suffered withdrawal symptoms when I first gave them up. This program of eating is finally a way of life and not a diet. Thank you for helping me to become aware.

DEAR READER: I am glad to hear that you have found a program that you can stick with. Weight loss on my diet isn’t going to happen overnight. As I have said in the past, the weight gain doesn’t occur overnight, so the loss won’t, either. On average, people on my diet lose up to five pounds in the first week (mostly water weight from the diet change) and then drop down to about one or two pounds each week after that.

To provide related information, I am sending you a copy of my Health Report “A Strategy for Losing Weight: An Introduction to the No Flour, No Sugar Diet.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure mention the title or print an order form off my website at www.AskDrGottMD.com.