Patient's question:
Hello doctor, I am 22 years old. I had my first menstrual period at the age of 15, and I have had a menstrual history for 7 years.Symptoms:
Since puberty, I have had severe facial acne that keeps recurring and is difficult to treat;
Poor breast development, with a development level of approximately stage II breast development. My bust size is only 77 cm. I am 155 cm tall, weigh 92 jin (about 46 kg), and have a sturdy bone structure;
Thick and masculine distribution of pubic hair (from the navel to the anus, extending beyond the inguinal area on both sides), long hair around the areola, and dense underarm, hand, and leg hair;
Long-term menstrual irregularity, with the shortest cycle being 30 days and the longest being 3.5 months. Generally, my cycle is between one and two months, with a regular 7-day period, normal color and amount;
I have had sexual activity and feel a strong libido. In the past two years, I have taken emergency contraception pills about four times a year (the kind in blister packs of two tablets each). During the medication period, my periods were relatively regular, occurring about one and a few days apart. Additionally, I once ate a lot of chocolate every day for three consecutive months, during which my menstrual cycle was stable at about one month.
Due to family reasons, I have eaten salty and greasy food since childhood. I am not overweight but have a strong appetite and a large appetite;
Traditional Chinese Medicine diagnosis: Insufficiency of the liver and kidneys, deficiency of both yin and yang in the kidneys, with more yin deficiency. In recent months, I have been relying on herbal decoctions to promote menstruation.
On July 30, 2012, the following hormone levels were checked (as I haven’t had a period for three months, blood samples were taken before the expected period):
1. Luteinizing Hormone (LH) 3.8 mIU/mL Reference: Follicular phase 1.9~12.5 Luteal phase 0.5~16.9
2. Testosterone (T) 52.4 ng/dL 14.0~76.0
3. Progesterone (PRGE) 3.15 nmol/L Follicular phase 0.48~4.45 Luteal phase 10.60~81.30
4. Follicle-Stimulating Hormone (FSH) 3.0 mIU/mL Follicular phase 1.9~11.6 Luteal phase 1.4~9.6
5. Prolactin (PRL) 12.1 ng/mL Non-pregnant period 2.8~29.2
6. Estradiol (eE2) 14.05 pg/mL Follicular phase 19.5~144.2 Luteal phase 55.8~214.2
Could you please tell me, based on all my current symptoms, what is the underlying cause of my menstrual irregularity? What should I do to confirm the diagnosis? What kind of medication should I take? I have just graduated from college and don’t know how much treatment will cost, or if it will affect my future fertility.
Right now, my main goal is to get rid of my acne and hirsutism. I’ve also been worried about not being able to have children in the future. I hope you can guide me in the right direction. Thank you very much!
Doctor's answer:
Hello, this situation is considered a symptom of endocrine disorder. Regulating the endocrine system primarily involves dietary and exercise approaches, supplemented by medication when necessary. It's important to develop good dietary habits, eat more fresh fruits and vegetables, high-protein foods, and drink plenty of water to replenish the body's required moisture. At the same time, participate in various forms of exercise to strengthen your physical fitness, maintain a regular lifestyle without staying up late, and keep a cheerful mood.