Irregular Periods & Heavy Bleeding: Seeking Medical Advice

Question
Hello, I have a couple questions I was hoping you might be able to help me with. I am 19 years old and I haven't had a period in 4 months. This is not the first time this has happened, I have had very irregular periods since I first started at 14. I first had trouble a few months after I started my period, I bled extremely heavily and was admitted to the hospital where I ended up having blood transfusions because my hemoglobin dropped to 5. To stop the bleeding and regulate the periods I was put on birth control but I had to stop the pill after a few months because of the side effects I was experiencing. Since then I have tried birth control twice, had multiple episodes of heavy bleeding, though I haven't been hospitalized since, and I have skipped periods despite not being pregnant (I checked). I'm not sure what's wrong with me but I have always suspected it was hormonal because in addition to those problems my hair has been thinning pretty quickly and I've had issues with depression. I know this is a lot but I'd like to hear your thoughts and if you have any idea what sort of doctor I should see I'd really appreciate it. Thanks for your time,
Hope

Answer
Hello Hope,

You definitely have an ovarian dysfunction, and the most common disorder is called "polycystic ovarian syndrome."  Disregard the term "polycystic" because it has no relevance to the problem other than if an ultrasound is done, the ovary has an abundance of follicles (cysts).  The basic problem is that the ovary is not functioning correctly leading to a hormonal imbalance.  I would recommend that you see a gynecologist or reproductive endocrinologist.  If you have already seen a gynecologist and the problem was not solved, then go see the RE specialist.

If you are not trying to get pregnant, then you need to go on some form of birth control pill.  In this syndrome, the male hormone, testosterone, dominates and you can have side effects from this hormone.  Hair loss is one such side effect.  Others are obesity, acne, lowering of the voice, increased facial and chest hair, increased cholesterol.  For that reason, the birth control is best because it gives back the female hormones.  The best birth control pill to be on is called "Yasmin" or another is "Yas" because the progesterone type, Drospirenone, also blocks testosterone receptors.

I hope this helps,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California U.S.A.