Teen daughter, no periods, GP blaming weight?

[mumofteenss]

My 16 year old DD has had 5 periods since she started her periods 4.5 years ago. When she got her first period she was of normal weight and height. She gained some weight in the first few years of high school when she quit sports clubs she had done when younger, She was considered overweight a year after her first period and not having a second. Now her weight is at the upper end of normal and has been for around another year, but it has been 18 months since her last period. Her BMI, though not always an accurate determine healthy weight i know, is 24.2, she looks in proportion and doesnt appear overweight. I have taken her to the GP numerous times, she has had blood tests, and an ultrasound for PCOS, these came back normal, bar testosterone which was high. GP is refusing any further investigation, and blaming her weight. She has basically said my daughter needs to lose weight and her periods will "kick in".

AIBU to think there has to be a medical reason as to how a teenage girl can only have had 5 periods in 4.5 years and want her to have some answers regarding future fertility etc now?

When she started her periods she started a tracker, so we can see he had a period June 2020, Aug & Sept 2021, Feb & March 2022, March 2023. She has no spotting between. She also suffers quite badly with acne. Any suggestions would also be appreciated. We have seen the GP atleast 10+ times regarding this issue over the years.

She is aware i am posting here for advice and was happy for me to share this information.

i've been overweight all my life and my periods have been regular as clockwork for 30 years.

I'd be seeing another GP, that is ridiculous.

sick to death of drs diagnosing women as 'fat' as a reason for all kinds of illnesses.

Jesus. I’d report that GP. That is shocking. Let me guess, older male?

Request another GP and push for a gynae referral.

Ohh not, that’s terrible.

My daughter has had infrequent periods but they are getting better I think. Will keep an eye.

What test and treatments are there?

Get another opinion. I’d not be happy with that for my child

Acne, lack of periods and high testosterone suggests something is going on - and could potentially be linked to her (slightly higher than it used to be) weight as well. Definitely worth trying to speak to a different GP.

What treatment is there for this?

Sounds like PCOS to me. You can have PCOS without any cysts on your ovaries.

The BMI you state would not be a period stopping weight. It's heavily overweight and underweight that does that. Is there any way of booking in with another GP in your practice? Unfortunately too many GPs don't take female reproductive system issues seriously enough. It's definitely worth pushing this.

You say your daughter's weight is at the upper limit of normal. She is not obese, she is normal. Teen girls' weight does fluctuate and making her self conscious about it doesn't help.

Being obsessed with periods is not helpful either. I used to go for ages without having one because my mum was on my back and it stressed me.

She is still young, it can take some girls longer for their cycle to get into a pattern than others.

Give it a bit longer and if you are still worried - more importantly, if she is concerned because it's her body and she's over sixteen, she can ask for a gynae referral.

Daughter is having Doxycycline for acne treatment and epiduo

DD is similar, 16 now, hasn't had a period since February, had about 2 last year. She started when she was 10 and they were fairly regular to start with and petered out a couple of years ago when she gained more weight.

She is under a consultant for something else, and he referred her to a dietician and did some tests. The dietician was of no help as she just told her "we need to eat things that we don't like because they are good for us". She had no understanding whatsoever about taste/texture/sensory issues that stop some of us being able to swallow stuff that tastes vile (to us).

He says the lack of periods is down to weight, but we see him again in a few weeks and I am going to mention PCOS.

I suffered infertility for 10 years. NHS refused to even consider PCOS as Im slim and previously was underweight. My hormone tests are normal.

I ended up doing private IVF and INSTANTLY getting diagnosed with PCOS.

There are 3 criteria to PCOS and a combination of any 2 means you have PCOS. The criteria are:

1. hormonal imbalance
2. infertility
3. polycystic ovaries

You can actually have PCOS without have cysts on your ovaries if you have the hormonal imbalance and infertility.

You can also (like my case) have cystic ovaries and infertility with no hormonal imbalance (so no visual obvious 'pcos' symptoms like weight gain, hair growth, excessive acne etc...).

Then there are also people who have PCOS by having a hormonal imbalance and cysts on their ovaries but they suffer no infertility problems (or can even be hyper fertile and at risk of multiples by releasing more than one egg per cycle from the cysts).

I wouldn’t worry about the scan. It only takes a couple of minutes to do a scan in a slim young woman with a full bladder. I don’t think she necessary needs an internal scan . Not a very nice thing to have at 16…
It does sound like a hormonal imbalance and I think it is wrong of the GP to give a young girl a complex about their healthy BMI.
I would probably sit tight for another 6 months before getting too worried as she is still young.

I don’t think there is much point asking them to do more scans and tests at GP level - this is what the specialist is for. Basically the GP isn’t likely to make a diagnosis for your DD.
they are info gathering and don’t have the specialist range for something like this, which is like a lot of other people are saying, a big picture of lots of other factors and likelihood - not just something on a scan or a blood test. I had normal internal scans but ovarian cysts present (and then removed) when they operated on me for something else. So I did have them just no one could see them until they went in. I also had high prolactin and they thought a prolactinoma (I don’t but raised levels)

This sounds like me at her age. I went on the pill to regulate my periods and deal with the acne. I was diagnosed with pcos at 30, having tried unsuccessfully to conceive for two years. At the very least there's a hormone imbalance that needs addressing, op.

Your daughter seems to meet the criteria for PCOS diagnosis according to the widely used Rotterdam criteria as she has infrequent periods, acne and raised testosterone. Ideally her bloods should be repeated on day 1-5 of her cycle (difficult when periods are infrequent) to confirm the raised testosterone. I’d go back to the GP.

Perhaps not so much of an issue at age 16 but women with PCOS who are not having any periods should have a bleed induced 3/4 times per year to protect from endometrial hyperplasia, medications such as norethsiterone can be prescribed for this.

I have PCOS and if my weight gets to 9 and a half stone my periods stop. I was overweight as a teen and my periods didn’t start til I lost it at 16.

As an aside I work in healthcare and weight is causing a lot of problems. High BMI is the new smoking.

"... GP is refusing any further investigation, and blaming her weight. She has basically said my daughter needs to lose weight and her periods will "kick in"..."

Methinks your prejudice is showing...

Her weight alone shouldn't be causing this. She needs to see a gynecologist.

Periods can stop when women are underweight.

Being overweight doesn't stop periods and is in fact a risk for endometrial cancer because fat increases estrogen levels and a thicker womb lining.

Can you not stretch to one private consultation?
Usually around £250. Hospitals for a private consultant appt take credit card payments.

Any further tests could be back on the NHS.

100% this. Definitely push to be referred!

I'm actually seeing a GP this afternoon with my 16 year old daughter, who hasn't had a period in a year. She started just before she turned 13. When her periods stopped aged 15 in the summer after year 10 (England), she was a normal weight. They didn't stop suddenly, but gradually became lighter then non-existent. She does a lot of sport.

We saw a GP in the Easter of year 11. DD had a lot of exam pressure (high achiever type), friendship issues, plus had lost quite a bit of weight and was at that point a little underweight (BMI 18 or 19). The absence of periods was put down to her low bodyweight. She was eating good quality food, but just not enough for her high activity levels. She was told to gain weight.

DD has now gained weight and is now a healthy BMI. However she actually looks overweight and sometimes pregnant, because much of the weight is on her bum and thighs, and she seems to be very bloated. She's always been a slim child and has never looked like this previously. It's like her spine is curved, as her stomach and bottom stick out a lot.

So we are now back to the GP in search of answers. Our fact pattern is clearly different from yours, but I've found reading about your journey to be really helpful. Please message me if you're interested in sharing info and supporting each other on this journey.

See a different GP - your daughter meets the diagnostic criteria for PCOS. You don’t need cysts on a scan for diagnosis, absent/irregular periods and elevated testosterone is enough. https://cks.nice.org.uk/topics/polycystic-ovary-syndrome/diagnosis/diagnosis/

Your GP is awful, her BMI is in the normal category. Get a second/ specialist opinion. Does she take birth control?