No menses? Lose weight, they’ll start again.

Gina writes:

I am extremely lucky to have pretty much no serious medical issues,
and can’t compare to some of the heart breaking stories already on the
blog. However, I still feel subjected to fat discrimination, and am in
a position where I can do almost nothing about it.

I started getting my periods at age 9 or 10 and had them regularly for
a couple of years. Around 8th grade they became and less and less
frequent, and eventually more or less stopped all together. Now, I
spot for one or two days about every 6 months. Other than that, there
is nothing. I brought this up several times with my doctor and his
only diagnosis is that I am too fat, and if I lost weight they would
become normal again. This is on top of a slow but steady weight gain
that started at the same time, and is completely unaffected by changes
in eating or activity levels. The primary topic of discussion at any
appointments, regardless of the reason I went, is my weight. He has
recommended Weight Watchers as a solution several times.

I feel that something is wrong, and worry that because of his ignoring
any problem that might be there, I will one day be rendered infertile.

Recently my mother told me he said that if my BMI was over 40 (it is)
that he would recommended a lap-band surgery for me. I am 16.

I want a second opinion, but my mom agrees with the doctor that any
medical (mental or physical) issues I may have are due to my weight,
and won’t take me to a different doctor. I don’t know what to do. I’m
leaving for college in the fall, and hope to be able to find a
different GP there that will take my concerns seriously.

Leave a comment

26 Comments

  1. Scarlette

     /  August 27, 2009

    I can’t believe this GP is recommending unnecessary surgery to a 16 year old girl?!?! Maybe your mom wouldn’t be so quick to agree if she knew about all the dangers and side effects of the surgery. Not to mention the possibility of death. You know your body better than anybody! If you feel something is wrong, then you would know! If your doctor and your mom won’t listen, I would suggest making an appointment for yourself with a different doctor, or go to a free clinic if you have to!

    Reply
  2. Pardon my anger, but your doctor is a idiot ass, and your mother should know better.

    My first thought is PCOS, polycystic ovary syndrome, and a google search for symptoms will bring up exactly what you describe. Early teen onset of symptoms, little to no bleeding, and persistent weight gain, among others.

    You need to see a gynocologist immediately.

    Reply
  3. lifeonfats

     /  August 27, 2009

    It sounds like the beginning of PCOS to me too. Do some research and insist that your mother take you to another doctor for a second opinion. A doctor who wants you to have WLS at 16 and disregards any other medical factors raises a lot of red flags for me.

    Reply
  4. Piffle

     /  August 27, 2009

    Yep, I thought of PCOS too. When I went off to college they required a health assessment that included a gyn exam. Whether or not yours does require one, at your age it’s perfectly reasonable to start seeing a gyn regularly. To make sure you get a different doctor (many GPs do gyn exams and you don’t want him!), insist on a female gyn for your first exam; and ask your Mom to leave the room too (you’re likely to have a nurse stay for the exam). Make sure you bring up your concerns with the gyn, she should take them seriously.

    If you have a friend who knows a good gyn, you can ask your Mom to see that one.

    Reply
  5. The weight gain and your loss of menses are probably linked (I lost my period both when I got too fat and when I got too thin), but the solution is far more complicated than just going on Weight Watchers. I third the PCOS suggestion. It could also be due to metabolic syndrome or hypothyroidism, the latter being quite common amongst women. I would recommend finding a good endocrinologist — who sees at least an equal number of thyroid patients as they do diabetes patients — to have an exhaustive range of tests done to determine what exactly the problem is.

    Reply
  6. J

     /  August 27, 2009

    I had the same situation. 4th on the PCOS. other symptoms include extra or thick hair, weight gain, acne, and my doc told me that my tendency to get tired after eating which i guess is a result of having your insulin messed up. Maybe read up on it and show your mom and ask if you can find a new doc.

    Reply
  7. J

     /  August 27, 2009

    PS everyone told me to see an endocrinologist, but when i talked to my primary care doctor, she ordered the blood tests and sent me to the hospital to get them done. she’s done all my treatment and i haven’t even seen a gynocologist (actually the only gyno i ever saw told me that i needed to lose weight a) to get my period b) to get pregnant and c) to be a good mom).

    Reply
  8. Check your local yellow pages for teen health resources. In NYC, for instance, The Door provides medical care to teens on a sliding scale.

    Reply
  9. Cara

     /  August 27, 2009

    First of all, you are a very eloquent 16-year-old, and your family and especially your doctor are handling this situation completely inappropriately.

    If you’ve gained weight steadily without changes to diet or activity and are not getting your periods regularly, then there may be an underlying condition causing the weight gain (PCOS, thyroid disorder) in which achieving weight loss without medical treatment for the conditions will be nearly impossible with any method, much less the evils of Weight Watchers (separate discussion!).

    I had a doctor once who told me, verbatim, the same thing. I dumped him and found a good one, who did extensive testing and diagnosed me with PCOS and Hashimoto’s thyroiditis (insufficient thyroid hormone production, which lowers your metabolism and messes with nearly every bodily function).

    You need a new doctor, and I know it’s probably your mom that controls the insurance coverage, but you might want to press harder to see someone else. I HIGHLY recommend a gynecologist and an endocrinologist, if that’s practically possible for your family.

    Here are a couple of links to infomation that might persuade your mom that the matter needs more attention:
    http://www.womenshealth.gov/faq/polycystic-ovary-syndrome.cfm
    http://www.pcosupport.org/
    http://www.mayoclinic.com/health/hypothyroidism/DS00353
    http://www.nlm.nih.gov/medlineplus/ency/article/000353.htm
    **Note: these are not intended to self-diagnose, but maybe they could help back you up for seeking a second opinion.

    Also, just an idea to throw out there, could you negotiate with your mom? Like, “if you take me to see a good specialist who is an expert in these areas, they do actual testing and make a clinical diagnosis that nothing is wrong with me, then I will look into a weight loss program.”

    Lastly, DO NOT even consider lap-band treatment before you’ve been tested 100 times and ruled out every possible medical condition. It’s not a permanent solution, and it can be risky in and of itself. Doctors love to push it now on younger and younger people without even exploring potential underlying conditions, and that’s a crime.

    I wish you the best of luck…be strong and stand up for yourself!

    Reply
  10. A lot of universities have on-site health facilities for students, which is paid for by school fees. Check if yours has one and make an appointment with an gyno–and if that one keeps harping on the fat thing, make another appointment with a different one. It can take time to find a doctor who doesn’t blame everything on weight, but they’re out there.

    Reply
  11. Mina

     /  August 27, 2009

    I just want to add encouragement for you to see a new doctor when you get to college… I too have PCOS and was only having a period every 3-4 months.

    Reply
  12. Even if you can’t make an appointment with a gyno at your university Planned Parenthood may also be able to help you depending on what services your local PP provides.

    I would insist on seeing a obgyn, and if they can’t find anything, an endocrinologist. I will also pass this along to a friend of mine who is a resident, she may be able to make some better suggestions.

    Reply
  13. KellyK

     /  August 27, 2009

    Nothing to add that others haven’t said already, just some encouragement and support. It sounds like PCOS to me, and I’m surprised that didn’t occur to your doctor. I totally agree with getting a second opinion from a gyn, preferably female, and going to either Planned Parenthood or your college’s health center if your mom isn’t willing to take you.

    Reply
  14. My family doctor used to prescribe my thyroid medication, but you really do need a specialist, in this case an endocrinologist, who specializes exclusively in endocrine disorders, which is ultimately what PCOS and hypothyroidism and metabolic disorder are. I highly, highly encourage you to see an endo. I switched from my family doc treating my thyroid deficiency to an endo earlier this year and it’s made a world of difference in how I feel. She even caught a couple things (severe deficiencies in vitamin D and B12) that my family doctor never even thought to ask about.

    Reply
  15. Dee

     /  August 27, 2009

    I also have PCOS – my period went wonky at about age 15, and I went on the pill and have been on it ever since. This is something you can maybe discuss with a doctor at your local Planned Parenthood?

    I steadily gained weight over the next 10 years, and its only in the last few months that I have been correctly diagnosed as having insulin resistance and properly treated.

    If you do find a new GP, the tests you want to do are a fasting insulin and fasting glucose test. I don’t know how the pathology labs work where you are, but this might even be something you can consider requesting as a private individual, and the tests are not very expensive. They are also fairly easy to interpret.

    And please… don’t let your mother talk you into weight loss surgery unless this is something that you have investigated very thoroughly. There are lots of potential complications.

    Reply
  16. @Rachel – Glad you have a good endo. There are poor endos out there too. My ARNP found my D and B12 deficiencies.

    Reply
  17. lilacsigil

     /  August 28, 2009

    I had a similar experience – started periods at 12, they went normally until I was 15, then I had maybe 1 or 2 a year. I also gained a lot of weight as soon as I hit puberty. I turned out to have both PCOS and hypothyroidism – but I wasn’t diagnosed until I was 26 because I was obviously just too fat to menstruate, even when I was actually not fat (BMI about 23, for those who believe in BMI) and just had a pot belly.

    Reply
  18. Mim

     /  August 28, 2009

    PCOS times a millionty!!!!!
    or, another endocrine disorder. without severely disordered eating (binges etc) steady weight gain and loss of menses *always* points to some disorder affecting the endocrine system.

    for some reason pediatricians seem particularly clueless about these types of disorders. a doc at college sounds like a better bet–find a gyn, explain, and get a referral to an endo.

    ALSO take control of your medical records as soon as humanly possible. your mother sounds utterly incapable of handling your medical situation, and you are right to be concerned about long-term effects of ignoring current problems.

    Find a doc who will send you a copy of their notes, and all test results (the actual numbers and reference ranges, not just normal or not normal). Talk about the issues with previous doc in the first meeting–what didn’t work (blaming it all on weight, pushing ww and wls), and what you would like from a gp/gyn/endo. Write it out if it would help you–you definitely express yourself well in this format.

    and…FIRE THAT ASS OF A DOCTOR!!!! and please, if you can, find out how to file a complaint at his practice once you have a new doc, and detail the ‘treatment’ you received, and why bringing up weight watchers and wls instead of treating your problems is not okay! it might do nothing, but it might change something for the better; you’d be making an effort to help all the other patients who might see this doc.

    best of luck, be well, have fun expanding your world at college!
    -m

    Reply
  19. plonit almonit

     /  August 28, 2009

    I strongly agree with the advice that you should see a gyno or an endocrinologist. I had the same symptoms as you, but I do not have PCOS — I have nonclassical congenital adrenal hyperplasia, commonly known as CAH. The New York Times did an article on it here http://www.nytimes.com/2009/07/07/health/07endo.html
    and the blood test for it is very simple. I have seen two endocrinologists, and found one that I love.

    If it helps, please tell your mother that many people who go on medication for CAH lose some of the weight they’ve gained, and depending on the medication, cease to gain weight, not that weight loss should be your primary concern. The idea that I might lose some of the weight was what convinced my mother to let me get tested for PCOS and CAH.

    Reply
  20. Pardon me if this is at all a prudent question, but have you been dieting lately? I know for me when I was at your age it wasn’t uncommon for me to skip periods at that long of a time span, particularly one span of 5 or so months when I seriously restricted my intake much lower than I should have and pushed myself physically much, MUCH harder than I should have. I was already one who’s periods were often infrequent and rather light and WAY off what was supposed to be the “normal” schedul of 28 days between bleeding and whenever I started one of my stupid crash diets again my periods became even more infrequent. My body just got weak but I just COULDN’T give up my damned diets so my body stopped wasting energy on functions not entirely necessary to survival, ie, menstrating.

    I don’t know much about PCOS, not having been diagnosed with it myself, but I’ve heard enough from others to where the symptoms you described first reminded me of my own whenever I restricted my diet far far too much yet again in a desperate attempt to get thin and second of accounts I’ve heard from women with PCOS.If there haven’t been significant changes in your diet I’d really suggest taking some of the advice given here and seeing a gyn before deciding anything. Something really does sound wrong and your current doc seems unwilling to accept that there could be an underlying factor aside from the fatz eating your ovaries.

    Good luck to you sweetheart, I’m so impressed with you for being so in tune with your body at age sixteen and even better to want to stick up for your right to seek the best care you can for it. I hope you can find a good doc who’ll figure out the problem instead of wasting his time shaming your for your weight.

    Reply
  21. Sarah

     /  August 28, 2009

    I too thought of PCOS while reading, though it could be other things as well. However, I had a doc apply extreme pressure on me to get weight loss surgery and did a lot of research, both for my own benefit as well as to show him that I wasn’t just being a ‘bad patient’ but had valid reasons for not wanting it. One tip for research is to try to look for long-term issues. You’re 16, if you get the surgery now, you need to know what the results will be 10, 20 years in the future when you’ll still be a young woman.

    Reply
  22. MargB

     /  August 30, 2009

    Just ditto to what the others said – my first instinct was “this sounds like PCOS” and “I hope this isn’t a symptom of something worse”. Get yourself to another doctor ASAP – you know your body best and if you think there is something wrong, there probably is; it just might take a few doctors and alternate tests to find what it is. Good luck. You deserve to be taken seriously.

    Reply
  23. thebluelotus

     /  August 31, 2009

    I’m yet another chiming in for PCOS and/or metabolic syndrome. I’d had hypoglycemia pretty much since puberty (though I hadn’t connected the two) and have either irregular or no periods without the aid of hormonal birth control. It was only just recently, at the age of 24, when I saw a doctor who recognized this and had me try metformin, which is actually a diabetes drug. If you are insulin resistant, all the extra insulin that builds up in your system can interfere with your ovaries and keep you from ovulating, which may be why you’re not having a period. Now my blood sugar is much more regular and I have regular periods again.
    Exercise can help your metabolism work better, which could help if you have what I do, but keep in mind that weight is also a symptom of other things, and not necessarily the cause. And extreme dieting can make your blood sugar (and insulin response) worse– I know it did with me.
    I also strongly agree with the suggestions to see a specialist and get a second opinion. Good luck!

    Reply
  24. la

     /  August 31, 2009

    Well in one respect, you are lucky! I think you have PCOS as well. Given your age, it would be great to have that diagnosed and get on the road to recovery right away. I have just realized, at the age of 46, that I probably have PCOS as well. I’m going to the doctor at the end of this month. Make sure you go to a doctor right away…if possible, an endocronologist. I’ve had some success with Weight Watchers losing weight, but keeping it off?????….that’s entirely different. That just doesn’t happen for 95% of us. Good luck and please do pursue this and get some help.

    Reply
  25. I’ve had PCOS since I was 9 and I’m now 52 and it sounds like what you have. Skip the GYN – a lot of them do NOT get it. PCOS is NOT a gyn problem. Go STRAIGHT to an endocrinologist, preferably one who specializes is Diabetes and related syndromes.

    Good luck and hang in there!

    Reply
  26. Rebecca C.

     /  March 3, 2010

    PCOS! My symptoms were weight gain, unusual hair growth (I had pubic hair on my stomach, wierd for a girl, especially of my skin type), acne, and REALLY high testosterone levels.

    Reply

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