Daughter’s periods have stopped?

[aspergersrus]

My daughter (who is 17) had regular periods from 15 until last June. She then had a small bleed in October but nothing since. We went to the doctor who ordered a small panel of bloods which came back normal.
She has lost a little weight in the past few months but this is down to cutting out sugar and being much more educated about what she is eating. We cook and eat together and I can see that she is eating well.
She is concerned about why this is happening and her future fertility etc.
The doctor told us to come back in 6 months and they will do more investigations.
Just wondering if I should push for those investigations sooner?
Does anyone have any knowledge to share?

Weight loss can affect periods
obvious question - is she sexually active?

What's her BMI?
Presumably you've done a pregnancy test?

PCOS?

It can be normal for periods to be irregular, especially as she was a late-ish starter. Can be down to low BMI, stress, obviously pregnancy.

Apologies if this sounds patronising, but I will ask anyway! Is she on any contraception? I see at least a couple of patients a week who are worried that their period has stopped, and it turns out they didn’t know that most contraception will cause them to stop bleeding.

She is not sexually active so pregnancy is not a concern.
PCOS is something that I have considered but I guess that’s something the doctor would look at. Her BMI is around 20

Is she exercising a lot?
Also experience has taught me that a lot of 17 year olds who are “not sexually active” in their parents eyes most certainly are…

Has she ramped up the amount of exercise she’s doing along with the diet changes? You don’t have to be an elite athlete for exercise to cause changes to periods, especially if she is already slender with low body fat. If medical tests aren’t showing any issues I would increase the amount of fat in her diet (can be “healthy” fats like avocado, nuts, Greek yoghurt, peanut butter) and reduce length and/or intensity of exercise.

I have considered the combination of her low ish BMI and stress maybe being the cause. She sets herself high standards academically and wonder if she puts herself under too much pressure. She is definitely not sexually active and she would have no issue telling me if she was as we have great communication

In the absence of pregnancy and hormonal contraceptive use, you could look up RED-S and see if she fits this description.

As others have said, dieting and exercise doesn't have to be extreme or the person look visibly undernourished, especially in adolescents who haven't long started menstruating.

I wouldn't be unduly worried, however I wouldn't let it go beyond 6 months without pushing for further investigation because very occasionally there can be an issue requiring treatment.

If it is related to calorie deficit and cannot be rectified with lifestyle modification, sometimes young women benefit from estrogen therapy to protect their bones if they aren't ovulating over a prolonged period. The contraceptive pill can be used for this purpose but isn't the only option.

This happened to my DD she was eventually scanned to look at her pituitary gland. All was fine and they just randomly returned after a year or so.

I think her body is sensitive to her weight/fat ratio. She was very fit and lean at the time.

THANKYOU everyone for your replies

My periods stopped when k was 16 and it was because I lost a lot of weight in a short amount of time. They came back after a year!

How can you be sure of this. You cant. Is she underweight?