Missed period secondary to stress.

Resolved question:
For the past year or so I have been noticing some strange changes to my menstrual cycle. Usually I get my menses regularly on a 28-29 day cycle. However in October last year I seemed to have missed my period and I had also experienced similar symptoms to pregnancy that month. Some of the symptoms included; serve fatigue, slight spotting, dizziness, lower back pain, frequent urge to urinate, sore breasts and irregular bowel movements. I am not currently on the pill or any medication. I exercise regularly and eat a very well balanced diet. I also sleep 8 hours a night but when I awake it feels like I didn't sleep at all.

I was tested for thyroid, hormonal levels, PCOS and urinary tract infection, did a pelvic examination and was also tested for pregnancy. All tests came back clear which was good but I am now experiencing the same problem again this month. This time the symptoms only include serve fatigue, missed period, urge to urinate, hair falling out and lower back pain. I am currently 3 days overdue and starting to worry a little about what is going on. Do you think it could possibly be a once of irregularity or could the previous results of the tests possible be inaccurate ? I also noticed that I did not ovulate this month with no PMS symptoms to follow - I usually get PMS symptoms prior to my menses. I don't have painful periods but find that I am often rushing to the toilet after meals.

Submitted: 4 Days
Category: OBGYN

Expert:  Dr. Aarti Vazirani replied 4 Days.

Hello
Thanks for writing to DoctorSpring.com with your health concern.

Some common causes of a missed period - anxiety, stress, personal or professional tensions, weight gain or loss, late nights, erratic eating habits, travelling, change in climate or season, smoking, drinking , ingestion of some medications etc.

If these are ruled out, then indeed hypothyroidism, PCOS and endometrial hyperplasia should be ruled out.
For this you need - a thorough internal evaluation, per vaginum and per speculum check up, pelvic ultrasound done transvaginally and hormonal levels - FSH, LH, TSH, Prolactin, OGTT, DHEAS, Free testosterone.
As it was done in October, get a repeat anyway.

Also, the symptoms closely mimic endometriosis, which is often a clinical diagnosis (digital exam by a gynec ) and missed on even ultrasound.
Laparoscopy is confirmatory.

Please have an evaluation ( did you take a pregnancy test this time around too ) - also, taking oral contraceptive pills or cyclical progesterone for 3 months could jump start your cycle and alleviate most of the symptoms.

All the best
Please feel free to discuss further.

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