Body fat needed for menstrual periods
DEAR DR. DONOHUE: I am 18 and have not had a menstrual cycle for five months. My blood tests showed that I do not have polycystic ovarian syndrome. My doctor suggested I go on birth-control pills, but I refused because of their side effects.
According to my mother, the reason I have not had a period is because I do not have enough fat in my body. My weight has dropped from 126 to 120 pounds. My height is 5 feet 4 inches. I exercise three times a week. Could my weight loss be the culprit of my irregular periods? — L.W.
ANSWER: I’m taking it that you have secondary amenorrhea, a loss of periods after having had normal periods. It’s an important distinction, since never having had periods (primary amenorrhea) generates a separate list of possible causes, different from the causes of secondary amenorrhea.
Fat aids in the production of estrogen. A female has to have at least 17 percent of her body weight as fat to generate periods. Fat has to constitute 22 percent of body weight in order to maintain periods. Your body mass index is 20.5, well within the acceptable bounds of 18.5 to 24.9. Body mass index is a fairly accurate assessment of how weight is distributed between muscle, bone and fat. I don’t believe too little fat is the cause of your trouble.
A loss of 10 percent of body weight in one year also can stop periods. Your loss of six pounds is less than 10 percent, so it most likely isn’t the cause either.
Since it won’t harm you and since you could stand to gain back the six pounds, why not make an attempt to do so? I don’t know the intensity of your exercise. However, if it is quite rigorous, cut back on it. At the same time, increase your daily calories so that you’re gaining one to two pounds a week. You can safely reach your goal in a month or so. If that doesn’t restart your menstrual cycle, your doctor has to investigate the somewhat-long list of other possible causes.
DEAR DR. DONOHUE: My question regards glucosamine and chondroitin. I have taken them for several years. It has been brought to my attention that this subject was written about in the March 2009 issue of the New England Journal of Medicine. The article indicated that a person with potential diabetes should not take it, as it can affect blood sugar. I am unable to review this article, as I am told the journal is restricted only to physicians. — M.B.
ANSWER: Glucosamine is a combination of an amino acid and glucose, a sugar. It might raise blood sugar even in normal people, but it doesn’t do so always. It’s a fairly small amount of sugar. You can find out if it influences your blood sugar by stopping it for a week and then having your sugar checked. If your blood sugar has dropped, then you can blame it on glucosamine. Glucosamine’s effect on blood sugar is something that’s been known for a long time.
Chondroitin is obtained from shark cartilage. It has no sugar. The two substances come in one tablet or in separate tablets.
These products are supposed to aid in the synthesis of joint cartilage and the production of the fluid that lubricates joints.
Anyone who wants to can read the New England Journal of Medicine.
DEAR DR. DONOHUE: I have taken glucosamine and chondroitin for five years for my arthritis. I believe they have helped me considerably. I don’t have the pain that I used to have. My doctor says I am wasting my money. Am I? I’d appreciate hearing what you have to say. — L.C.
ANSWER: Two large studies, conducted by the National Institutes of Health and involving a large number of people, showed that either product, alone or in combination, did not do much for any kind of arthritis.
However, if you feel better taking them, then go ahead. You’re as good a judge about your arthritis as anyone is. Furthermore, you’re as good a judge about the effects of medicines for your arthritis.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.
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