Common Period Problems

I am 18 years old, have stopped having periods and have gained weight. The pregnancy test is negative. What could be going on?

This also sounds like secondary amenorrhea. Pregnancy is the most common cause of secondary amenorrhea, but all of the other causes are not normal. A person can have a "post-pill" amenorrhea when discontinuing birth control pills until the pituitary gland resumes normal function after being blunted during the time on the pill, and this is fairly harmless. The same applies after depo-provera shots and other hormonal manipulations.

But there are other more suspicious reasons to experience secondary amenorrhea. An ovarian cyst (benign, pre-malignant, or malignant) can interrupt the cycle. A benign condition called polycystic ovarian syndrome (PCOS) puts your cycle on hold because you can't ovulate. This interruption causes a build-up of testosterone and weight gain. Many doctors would recommend a serum testosterone level to see if it's elevated, an ultrasound to check for cysts of the ovaries, and of course a thorough physical exam. If all of this turns up nothing, then it's possible that becoming overweight has caused production of extra estrogen from your fat cells, which will muck up the works. And then there is the consideration of premature menopause, which at your age is extremely unlikely. A simple blood test of your FSH could be done at the same time as the serum testosterone. You should be evaluated by an OB-GYN.

I had a baby two months ago. It just dawned on me I’ll get my period again eventually! When should I expect it?

Most physicians say as early as two months, so it could be any day for you. If you are breastfeeding, it is likely to be longer. Some women don’t resume their menstrual cycle until they wean their baby. But (unhelpful as this is) not all of them. So the best advice is just to be prepared! Keep some pads or tampons on hand, and realize that postnatal lack of a period does not guarantee contraception! Your first ovulation may happen while you think you are still not cycling. (If you’re concerned about getting pregnant, check out Birth Control Options for New Moms.)