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.

Loses the weight. Then this factor can be excluded. The blood tests were clear…except for testosterone, right? Dr thinks testosterone high due to overweight.

If she loses weight, and the testosterone decreases ?
If periods return, then all is well.
If testosterone decreases, weight decreases but still no period, then she is in better health and can explore other reasons.
IMO, MD/Dr knows more than me or others. Would take Dr advice.

I can’t believe people saying that a teenager who is a healthy weight should be asked to lose weight. 16 is a tough age and as she is already active and eats a balanced diet according to the OP, telling her to lose weight could just cause a whole other set of problems.

GPs aren’t specialists and they can be wrong.

You need to see an endocrinologist
we paid for an initial consultation with a private one. Then onto nhs teenage endocrinology. Lots of blood tests and scans. Your case sounds just the same as us. Diagnosed with PCOS. Feels like it has robbed her confidence, weight increased, anxiety etc
don’t be fobbed off

Sorry, i only read the first page so don't know if mentioned already but she needs her blood tested for prolactin. This is a common reason for periods to stop.

If levels are high, she needs an MRI scan (a CT is useless ) to look at her pituitary glad and see if there is an adenoma there.

If this is what it is - no need for alarm! Technically, it is a kind of tumour but it is always benign. Treatment is really simple - a tablet called cabergoline is taken once weekly and the periods restart and full fertility is restored.

The adenoma will be monitored every year or so to see it hasn't grown. Worse case scenario is it grows and interferes with vision - but it can be removed if that happens. Normally it doesn't cause a problem and can be left in situ totally safely.

Definitely see a different GP and then push for a Gynae referral. Please don't be fobbed off.
I have PCOS and it affects your whole life.
What you have described about your daughter is me at the same age, one or two periods, awful acne all over, a similar BMI but I also have a lot of bodily hair. I had high testosterone levels but they couldn't see the cyst on my ovaries until an internal exam and even then they come and go with fluctuating hormones.
I was treated with Dianette contraceptive pill (this really helped but not sure if it's still prescribed), and strong antibiotics for the acne prescribed by a dermatologist. It was very difficult TTC because I hardly ovulated but thankfully with hormone treatment I have two children.
I've probably had fewer than 15 natural periods in my whole life and I haven't had one for at least 10 years and I'm now 45. I went through the menopause about 8-9 years ago and I take HRT. I also gain weight very easily and still have really bad teenage skin :(
Without my PCOS diagnosis I would not have been able to understand why any of this was happening and help to treat it!

To see a private gynaecology consultant costs around £150-200. I did this and was then referred into the NHS for treatment.

Exactly, it's a red herring.

I would not tell your DD to lose weight, but I would say that a higher protein, lower carb diet could potentially help her hormones. That's not the same as telling her to lose weight.

I wouldn’t take her back to that particular GP but I would be wanting a referral to gynae by now who can do further tests. There’s clearly something amiss and telling someone, especially a teenager with a healthy weight that her periods “should kick in if she loses some weight” is ridiculous. I honestly can’t believe the attitude of some doctors- makes me grateful that although it’s often a long wait for a gynae referral, our GP referred my teenage daughter quite quickly when the various versions of the pill weren’t helping her. So glad they did- she’s on the list for endometriosis surgery but in the meantime they can help her a bit more with the pain management side and the horrendous symptoms in general than the GP could.

Interestingly enough, neither the consultant or the nurse who specialises in endo who we’ve seen so far have referred to endometriosis as a “label”. That’s quite galling to read when you routinely see your teenage daughter sobbing, writhing in pain and unable to eat, sleep or get to the loo on her own when the pain is really bad.

@MrSeptember
"post menopause, do you find it easier to lose weight, and keep it off. A doctor told me that as I enter into perimenopause tha tmight happen to me but no sign of it so far!! I am losing weight currently, slowly, with intermittent fasting so I'm happy, but I've yet to find real success with traditional weight loss of just fewer calories, less fat etc.

Yes I do, after a lifetime of struggling to keep my weight down I now maintain a healthy weight easily, no more dieting after 40 years of constantly trying to lose weight & keep it off.
Excess body hair went away too.

To clarify.

The surgery receptionist gave me blood results over the phone, mentioning the 3 levels, LH, FSH, and testosterone. I requested a follow up appointment to discuss these in detail.

We then had a follow up appointment with the GP, who said her markers for PCOS were in range, the LH and FSH. Testosterone was not mentioned to us as a marker, or relevant at all in fact, to a possible PCOS diagnosis. The only bloods mentioned at that appointment were the LH and the FSH. I asked what the next steps would be, this is when she mentioned weight initially, which by then was considered normal, and she said that we could maybe could refer for ultrasound. I said ok do that, if it going to help figure what is happening. So she did, 6 months ago. We didnt have any GP appointments in the mean time as we were waiting for the ultrasound.

6 months later she has had the ultrasound which shows normal ovaries. I called for the results yesterday morning. The GP has said "no further investigations, just lose weight, periods will kick in and become regular"

At no point, in the 6 months, has the GP mentioned the testosterone being a marker, or indicator, or part of the criteria for diagnosing PCOS. So yes, yesterday when i posted i initially felt fobbed off and didnt know how to advocate for my daughter. This thread, the replies, and advice, and links shared, informed me that that blood test was relevant, and infact, a diagnostic result.

The GP never said weight loss can correct testosterone. The GP never spoke about this result. This is why i called the practice and spoke the to the manager, as i feel the GP misled me regarding my childs health, as when she spoke about PCOS investigation's, she only mentioned the 2 blood tests and ultrasound. She bypassed, completely, a result that 6 months ago, would have led to a PCOS diagnosis, as, 6 months ago, she had the high testosterone, and no periods, which i now understand is enough to diagnose the condition.

So no. Im no longer "taking her advice". As the information she has given me ive now found out was lacking very relevant information. And she very clearly does not know more than others, since others on this thread have linked to NICE guidelines, which state very clearly, her advice and response was wrong.

my last post was supposed to quote @pointedlypointless

there's hope for me yet.

I have been fascinated with IF to see that in the two weeks I'm on progesterone as part of my HRT.... that's when I lose weight. In the two weeks I'm not, my weight fluctuates a LOT, trending overall higher. Then in the first few days of progesterone, it slowly subsides back to previous low, then in the 7-10 days before I stop the progesterone is when I actually lose weight.

Please do specifically ask if they checked prolactin. See my post above. Such a simple and easy fix if this is it.

You're doing the right thing and honestly I am still bamboozled your GP was only look at LH and FSH. These rise and fall through your cycle so they are only reliable if you were to track them every day or week and to already know what her rough cycle is - but your daughter doesn't so what is the use of only using these?? Testosterone is the one to look at - it's just so bizzarely basic knowledge for a GP to have so I would even put in a formal complaint about the GP for delaying a diagnosis needlessly for half a year.

I'm so so glad you're not going down the line of weight loss. Everyone going on about weight loss is missing the point that with PCOS it is hard to lose weight and when you do, depending on the way you do it, you risk harming your hormones which will make it worse. I was 9 stone and had no period. I'm now 12 stone and have a 28 day cycle. I am losing weight currently (very slowly and mindfully and stress-free) but I needed to gain that weight and heal my relationship with food to heal my hormones.

PCOS is so much bigger than menstrual cycle and fertility. I had no idea for years that the exhaustion I felt through the day, the brain fog, the headaches, anxiety, was all rooted in my messed up hormones! I feel great now - and I'm 3 stone heavier!! Drs aren't educated on this so they say lose weight and/or I'll give you the pill/fertility treatment, and they forget the impact it has on every other area of your health and wellness.

I feel very passionate about this I'm sure you'll see 😂

Others have linked Glucose Goddess videos which are helpful so I wanted to share my fave Abbey Sharp who is a dietician who has PCOS too. If you search on Youtube "Abbey Sharp PCOS" you'll see lots of her videos but this is a good one. If you go to around 14 mins it talks about how dieting can worsen symptoms:

I've learnt that regular doctors (Even the gynae for some reason) still don't understand PCOS so you need to seek out private help from PCOS specialists, specifically dieticians who take a holistic approach looking at stress, diet, exercise, sleep, supplements, etc as it's a multi-pronged approach.

Once you have a diagnosis I promise it's not that hard to manage for most women as long as you have the right information (which is why I really recommend https://www.thepcosdietitian.co.uk/ - she is my hero 😍

Edit: also to add in that I got prolactin and thyroid function checked too when I was diagnosed to rule out other causes. If there's a thyroid issue at play too then she'll need medication to fix that on top of other changes. My dietician said not to bother doing bloods for insulin/blood sugar as it won't tell you much. Some women also find they are intolerant/allergic to some foods like dairy/soy/gluten or have coeliac disease but it'll become obvious if these are issues later if she adapts her diet macros/takes supplements/watches stress etc.

Sounds like GP is the sort who would have said the same if periods were heavy Insist on a gynae referral

What is wrong with the truth. How do you think you should tell your daughter about what her body is saying?

GP sounds very unreasonable. Has your DD been tested for an underactive thyroid? This can also stop or slow down periods. Definitely ask for a second opinion.

I would agree with this.
I had the same challenges in my teens and my father took me to a private gynaecologist for a second opinion. The first ultrasound revealed severe PCOS and this was treated with the combined Pill - that's all there was then in the 1980s, but at least I had the diagnosis.

My cousins daughter is 18 and only ever had about 5. She is on the larger side and always has been. Had every scan going and nothing is wrong. My cousin was told it was her weight at every appointment and she needed to think about what she was eating and start exercising. She didn’t eat healthy, yo-yo diets and rarely exercises, more of a bookworm and homework kind of girl with a limited social life. A private gynaecological assessment was booked a year later after nothing and again nothing wrong but the same advice, diet needed an overhaul and she needed to get out and exercise. She had about 1 stone to shift. After shedding 1/2 stone her periods came back monthly. She wasn’t happy about having a period so deliberately stopped dieting and exercising and put it back on again. Periods stopped again. She’s happy being period free and a stone overweight knowing nothing is actually wrong with her.

I’ve just posted about my cousins daughter but I want to put it out there that women and girls healthcare is absolutely atrocious to say the least. Perimenopause here and fobbed off for 4 years knowing I wasn’t right. I had to fight when I didn’t have anything left to give to get a diagnosis and hormone treatment. I honestly thought it was all in my head and what doctors told me at the time kept instilling that. Please keep up the fight, it’s not easy but someone out there will help. You just need to find them. Good luck and love to your daughter.

Bull shit

Plenty of overweight women have regular periods

I do

High testosterone levels would account for both the lack of periods and the testosterone levels, probably the weight as well. Could you have her privately seen by an endocrinologist?

She needs to be referred to a gynaecologist- a GP would have no way of diagnosing or treating any other issues. Being slightly overweight wouldn’t be a reason for periods to stop (just like being slightly underweight wouldn’t be - it’s the extreme over or under that would stop them).

Ahh but are you on the "larger side and always has been" 🙄

Otherwise @BooBooDoodle won't believe you.