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PLEASE HELP DIAGNOSE IF I AM IN MENOPAUSE Dear Dr. Mazumdar, I am 33 years old and have just been diagnosed with menopause. My periods abruptly stopped about 6 months ago after 2 months of extreme stress with a new stressful job and a personal tragedy in July of last summer. I also began exercising more and lost about 10 pounds. I also came down with mono. All of this happened at the same time. Could there be something else going on other than menopause? Or is this an accurate diagnosis? Not married and still want kids. Please help me to deal with this situation and face the facts one way or the other. Thanks MN, Age: 33, Texas REPLY MN, When did you get the tests for the FSH and estrogen level? Has your LH level been tested? Did you get an ultrasound to check the status of your ovaries? FOLLOW-UP I got these hormone levels tested last Monday morning 3/3/07. Yes, my LH was tested and it was 85.8, my Prolactin level was 9.3 and my TSH was 3.6. An ultrasound was also done of my ovaries which showed a small cyst on my right ovary but I don't have any pain associated with the cyst. Should I get these hormone levels rechecked or should I just accept the fact that I am going through early menopause? Thanks REPLY The menstrual cycle is maintained by inputs from the cortex of the brain which handles emotions, thought etc. These inputs come to the hypothalamus which releases FSH and LH releasing hormones. These hormones stimulate the pituitary gland to secrete FSH and LH. The FSH and LH stimulate the ovaries to ovulate and the menstrual cycle is initiated. A high level of FSH and LH (and yours are high) indicates that the pituitary is releasing the hormones but the ovaries have failed to respond to these hormones. As a result, they have not ovulated and have not secreted estrogen and progesterone. Since your periods stopped suddenly after a period of extreme stress, there is a chance that your amenorrhea is due to an acute hormonal imbalance caused by the stress. A single hormonal readng does not indicate menopause. You need to get three readings at monthly intervals. If these still indicate menopause, please ask your Obgyn to check your ovaries for the presence of follicles. You also need to get a Clomiphene Challenge Test. This means that you will be given a medicine called Clomiphene citrate (Clomid) - this causes ovulation. If you ovulate or your ovaries shows growing follicles on ultrasound, it is possible that you may resume getting normal monthly cycles. If your ovaries fail to respond to the clomiphene challenge test, then I am afraid that you will have to resign yourself to being menopausal. Menopause at 33 years is not unknown but is very rare. It is better to get all tests before actually diagnosing menopause. I hope this helps. Please feel free to ask a follow-up question if you wish to know more. MN paid $20 on November 10 2008 at 12:40 AM Previous : Next Read Questions asked by other Users on this Site: On Breasts On Menstruation On Pregnancy On Infertility On Birth Control Methods On Sexually Transmitted Diseases (STD) On Sex On Male Sexual health On Other Miscellaneous Questions Bookmark this page Digg it! Stumbleupon Facebook del.icio.us Web www.gynaeonline.com Go Top

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