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What could be the reason for irregular scanty periods?

Q: I am a 24-year-old unmarried girl. I have irregular periods. One month I got them on 29th. Next month I got them on 25th but only a few drops, which I don't consider as periods. I never got them the months after that. I went to the doctor who suggested some tests like CBC, TSH, urine HCG. I am a working woman and I couldn't manage the time for the tests. Then I went to a private clinic for a second opinion. The doctor recommended the following tablets: Deviry (10 mg) – 1 daily for 4 days; Pyricontin - 1 daily for 15 days; Zi Cal M – 1 daily for 15 days and Ferium XT – 1 daily for 15 days. I visited the doctor again after 4 days and told her that I didn't get my periods. She gave me an injection saying that will get my periods within 5 days. She told me to continue the tablets as suggested except Deviry and Pyricontin. I got my periods. I visited her after three days. She told me to continue with the medicines suggested and also prescribed to take Duoluton–L one daily for 21 days from the 5th day. She told that if I skip a day, it would result into some blood clots etc. I was a bit hesitant to continue with this medication, so I visited my earlier Doctor who told me that the last medicine prescribed is an oral contraceptive/steroid and there is no need to take it. She told me to discontinue with the treatment and just take one iron tablet Haematinic Autrin Capsules. Now I am confused. Even I feel like stopping the medication given by the private doctor. What was the actual problem and can I stop all the treatment and start taking haematinic Autrin Capsules? I don't want to face any problems in future.

A:Your problem is called by doctors a case of secondary amenorrhoea, which means the absence of menstruation in a woman who has menstruated previously. If pregnancy is excluded with certainty, there remain three major causes for the occurrence of the phenomenon: 1. Premature menopause, which can be excluded by the determination of the blood level of follicle stimulating hormone (FSH) (it is elevated in case of premature menopause); 2. The so-called polycystic ovary syndrome, which can be excluded by the determination of the blood level of luteinizing hormone (LH) (it is much greater than the level of FSH, in case of polycystic ovary syndrome); 3. Hyperprolactinaemia, which can be excluded by the determination of the blood level of prolactin (it is elevated in case of hyperprolactinaemia). Hence, one should start in your case by 1. Excluding pregnancy, and 2. determine FSH, LH and prolactin levels (blood should be drawn preferentially between 10:00 AM and 12 noon), and proceed from there. Until the cause is known, no medication must be taken.

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