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An_249953 posted:
today is 1/18/13, i haven't had a period in 3 months. taken several at home tests all come out negative. now i'm having bad lower back pain that radiates to my left side/groin area. i have a history of having ovarian cysts. could these symptoms be related or just two separate things happening at the same time?
i have a 3 year old, shortly after having her i missed my period for about 3 months, went back on the pill and the problem fixed itself. not on the pill now, and not wanting to go back on it either.
any advice or help would be greatly appreciated. (yes i know that i should go to the doctor, and probably will. i just wanted to see if anyone else had ever had something like this before)
Jane Harrison Hohner, RN, RNP responded:
Dear An: If the pregnancy test is negative then the next most common cause of a missed period is not having ovulated that cycle. In a normal cycle, estrogen is produced all month. Estrogen is responsible for building up the lining of your uterus so you have something to shed each month.

In a normal cycle, progesterone production increases following ovulation. Progesterone "stabilizes" the uterine lining in preparation for a possible implantation of a new pregnancy. If you are not pregnant that month the levels of estrogen and progesterone fall, triggering the release of the uterine lining—your period. So, if you do not ovulate, the estrogen build up of the lining continues, but without the usual ovulation associated progesterone. Thus, the hormone levels don't decline, and the lining stays up inside the uterus—your missed period(s).

If you have been several months without a period, a gynecologist may give you some progesterone in a pill form (eg Provera 10 mg for 5 days). Within 48-72 hours after stopping the progesterone your "progesterone blood level" will fall, triggering the release of the lining that has been building up. Many women report that these periods are very heavy-- as though several months of lining are shed.

There can be MANY causes for not ovulating: low thyroid, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with partners, children, finances), increased body weight, anorexia, rotating shifts at work, etc. In your specific case, the pain MIGHT be from an ovarian cyst--and a cyst can interfere with ovulating.

There is a second, less common cause for not having a period. In some women the estrogen levels become very low. The levels are so low that no uterine lining is available to be shed. When these women are given the progesterone pills to take, no flow occurs after the medication is finished. This tells the GYN that the woman is not making enough estrogen to produce a thickened uterine lining. Fortunately, this "premature menopause" is relatively rare.

Yes, after three months of a missed flow AND the left sided pain you should see a GYN. A brief in office ultrasound should be able to confirm an ovarian cyst if present. They can also prescribe a short course of progesterone type medication if indicated.