Secondary Amenorrhea PCOS

Dear Ask The Doctor: I am 20 years old, about to turn 21. I first started my period at 13. I was never really 'regular.' I'd usually only get my period 3-4 times a year. At 17, my ob-gyn suggested taking birth control pills to regulate my cycle. I took them for about two years and got my period about 8 times each year. I stopped taking the pills in January of 2009. Since then, I have only had 2 periods, one in November 2009 and one last week (April 2010). Each of these two periods only lasted approximately 2-3 days... It was mainly spotting, not even a full period. I am not pregnant. I suffer from depression, so I am also experiencing the usual symptoms that come with the illness. What could be the problem?

Dear Melanie: I understand your situation. Irregular Menstruation Mostly is benign, early presentation, late presentation, missed periods, spotting or increased Menses volume is usually caused by a Hormonal Imbalance.A wide variety of factors can be responsible for irregular periods such as weight gain or loss, Over-exercise, Poor nutrition, Smoking, Caffeine, Eating disorders, increased stress and Polycystic Ovarian Syndrome/estrogen dominance or other conditions that interfere with estrogen Metabolism. Certainly Stress can influence by altering the Hormones release from the Adrenal Gland which influence as well on Sex Hormones.I will suggest you to have a complete physical, including evaluations of thyroid function and blood pressure since Depression symptoms can also be confused with Thyroid problems. Also, a complete blood count (CBC) test is quite important for the diagnosis of anemia. A pelvic exam is critical to rule out any uterine abnormality, a cervical polyp or fibroid. Often an ultrasound will be required to evaluate the uterus, the ovaries and the fallopian tubes. All these test plus a more detailed Clinical History will help your Gynecologist rule out the exact diagnosis. If Oral contraceptives helped you before, you might need to start taking them again after your doctor evaluates you. I wish you the best.