Almost 19 and no period for 20 months

Hi,
I will first give some back ground information, I have a girlfriend that will be 19 early next year, and she has not had her period for close to 2 years now.
She has stomach pain all the time, and has gained a few pounds, she has been to a number of different docters, as well as several visits to a gynecologist, and about a month ago had exploratory surgery to see if that would reveal anything, and it did not.
Her docter told her last week that everything is fine, just go home and rest.
However, the gynecologist said that if things do not change soon she might not be able to have any children, as well as a increased risk of cancer.
I am starting to feel like things are not really under control.
What are your thoughts or suggestions on this matter?

[Rakhi Tayal, MD]

Dear ErikCanada,

Thanks for posting your query.

Not having any periods for last two years at the age of 19 is not normal. I would like to have some more specific information to give you a more informed opinion in this regard.

1. Was she taking any contraceptive pills?
2. For how long is she noticing  weight gain?
4. Does she have any chronic illness such as tuberculosis?
5. Which hormone tests has she undergone?
6. What were the findings of the exploratory surgery that was performed?

Do get back to me with the above information so that I can guide you better. I look forward to your follow-up.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards.
Dr. Rakhi Tayal

[ErikCanada]

Hi,
She has never used birth control, and does not have TB.
The weight gain has been within the last 10 months, and it is about 5 lbs or so.
She has not taken any hormone tests, and the doctors who proformed the surgery said they found nothing abnormal.
She had a xray yesterday, and is having a ultrasound and a blood test today, asd will learn the xray results.

[Rakhi Tayal, MD]

Dear Erik Canada,

I understand your concern. You have provided good information, though I understand you may not know some details of your girlfriend’s medical history.

I have gone through the details provided and I feel that she needs to have a detailed examination by an experienced gynecologist. She must get her thyroid profile, serum LH, FSH, Prolactin, complete blood picture, and ultrasound scan done to come to a diagnosis. You have mentioned that she underwent an exploratory surgery to find out the problem. Such a decision would not have been taken without a thorough evaluation of her hormonal status and other investigations.

While evaluating such cases, I think a testing protocol should be followed according to which she should get the following investigations done in the order given below.

1. Pregnancy test.
2. Check Prolactin and TSH levels
    a) If both normal-Progesteron challenge test, and further tests.
    b) TSH level. If abnormal: MRI.
3. Estrogen and progesterone challenge test.
4. FSH and LH levels.
5. Hysterosalpingogram.
6. Diagnostic laparoscopy.

Surgical interventions are always the last option.  I suggest you discuss these tests with her treating doctor.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards.
Dr. Rakhi Tayal