Infrequent periods

[namechangeabc]

Bit of background - DNiece hit puberty at 11 (Bra / hair) but was almost 14 before her periods started. Once she started she was regular. My Mum (grandmother to DN and DD) was over 16 before she started.

DD started wearing a bra at 11 and moved steadily up through the sizes. At 14 she was a C cup, so very curvy, but no periods. She had her first period the month after her 14th birthday. However, she didn't have her second period till 15 months later. She spoke to the school nurse a couple of times who said not to worry till she was 16. Third period came 8 months after the second - she'd just turned 16. That was 4 months ago and there's no sign of a 4th period. The school nurse has again said, don't worry, it's normal to take a while to settle. DD is happy to talk to the school nurse, but doesn't want to see a doctor (especially as school nurse says there's no need).

DD has a BMI of 23, so a healthy weight, and though she's very active (drama club/ school music group / brownie helper / youth club / often accompanies dog-walking friend) she's not particularly sporty.

Is the school nurse right - is this ok?

[schoolchauffeur]

bump for this one- interesting topic. I think the nurse is right it does take some time to settle, but I had been told that that should be within a couple of years of periods starting. My DD started at 12, was sort of regular- say every 5- 6 weeks or so for 2 years and then for last two years only about 3 periods a year. She spoke to her GP who said that ( due to some other issues at time) it may have been slightly stress related, she is also a little underweight ( no idea why as she eats lots!) so she is to go back at Christmas. Only had 3 periods this year- Feb, March and July.
Anyone got any more info?

[notcitrus]

Not starting periods until 14 (with rest of puberty younger) and then being infrequent can be a sign of polycystic ovaries - might be useful to be aware of potential other symptoms just in case. Most symptoms can be kept under control with a contraceptive pill but it can be more difficult to get pregnant later. And harder to lose weight and symptoms can be exacerbated by excess weight, so more important not to put it on, if at all possible.

But apparently 20% of adult premenopausal women don't naturally have regular periods, so it's really not unusual for a teenager.

[namechangeabc]

Thanks, notcitrus. If it is polycystic ovaries is there any advantage is getting it diagnosed sooner rather than later? If we continue to ignore it, could her ovaries be damaged?

According to the NHS site the other symptoms are
a) excessive body hair - she seems a lot hairier than me, but that might just be because she has much darker colouring than me. Also, with most women keeping their legs hair free I'm not sure what "normal" is!
b) acne but she's definitely not got that; her skin is very clear, with an occasional dry patch in winter.
c) weight gain - not really. She's not skinny (BMI 23) but has an hourglass figure, carrying weight on her chest / hips /bum, but she has a neat waist. She's been a fairly steady BMI 23/4 for the past few years. She's never tried to manage her weight either.
d) hair loss from the head - no.

[notcitrus]

Dunno, but I'm not actually a medical doctor! I think the cysts are just a symptom of not ovulating properly, though in a few cases they can grow huge and cause pain. The treatment recommended if you don't want to get pregnant is a contraceptive pill plus avoiding weight gain, and maybe metformin if symptoms are severe (and usually if trying to get pregnant).

[panicnotanymore]

I had PCOS from early teens and had the same issues with periods as your DD. I was underweight if anything, so it is not true that everyone with PCOS is overweight. The diagnosis is a bit traumatic for a teenager as the scan is an internal vaginal one.

PCOS is often linked with insulin resistance and thyroid problems so it is worth getting her to a good gynaecologist. I have been able to manage my PCOS through diet - I eat low GI carbs, protein at every meal and avoid refined sugar. My ovaries are clear, and I was able to get pregnant easily. It is not always a huge problem.

One bit of research that my endocrinologist was working on was the link between PCOS and bulimia. Again, not everyone with PCOS is bulimic, but there is a link, so it is something to be aware of.

[Puremince]

Thanks, panicnotanymore. Do you think I should push DD into seeing a doctor? A internal exam would probably be very traumatic - she doesn't intend to use tampons, and as she's only had 3 periods tampons haven't been an issue. I think if she thought an internal was a possibility she'd be horrified.

[panicnotanymore]

It wouldn't do any harm for her to see a doctor, and maybe have some blood tests done to check her hormone levels are where they should be. They will probably check thyroid as well as reproductive hormones. She may well be ovulating perfectly normally, but just not settled into a proper cycle yet. I wouldn't put her through an internal scan at her age.

Most GPs recommend the pill to manage PCOS. Avoid dianette, it is great at managing the symptoms, but has horrible side effects. It made me really unwell - irrational, moody, bloated, angry.... Not good!

I'd recommend trying diet control before metformin. All metformin does is lower blood sugar, and you can do that yourself by eating low GI, and cutting out sugar.