I am 25 and have always had regular periods. I had a child when I was 17 and had no trouble conceiving then. About nine months ago my periods became very irregular, skipping two to three months. When they did come, I had only light spotting. I have been trying to conceive for a year now and have had no luck. My OB/GYN says everything is fine and no tests are necessary despite my lack of periods for four months now and my inability to conceive. I am worried that I am going through early menopause, especially with other symptoms (vaginal dryness, lack of libido, mood swings, excessive sleepiness). I had my thyroid checked within the past year and it was normal. Isn't there anything my doctor should be doing to figure out what's going on?

Betsy

While premature menopause is one possibility, it is not the most likely cause of your menstrual disorders. There are more obvious causes such as thyroid problems, polycystic ovary syndrome, insulin resistance, type II diabetes, genetic abnormalities, exercise, medication or adrenal enzyme defects. Your doctor can certainly test for many of these disorders. The list of available tests is extensive.

In any case, your irregular periods should not be ignored. Lack of a regular menstrual period has also been associated with precancerous changes in the endometrium (uterine lining) or actual endometrial cancer. If an imaging test called a transvaginal ultrasound indicates a thickened uterine lining, that would suggest you need a uterine biopsy (a procedure to take a sample of tissue). Endometrial cancer does not look for older women to strike. This cancer has been found in young women, too, particularly ones with infrequent periods.

I am disturbed by your physician's unwillingness to complete the necessary medical evaluation. Your doctor either lacks the interest or knowledge to adequately address your medical situation. Testing is definitely required to rule out cancer and other medical conditions that may cause problems for you in the future. By sharing your concerns with the local medical society and your insurance carrier, you may help other women avoid this sort of indifferent care.