Concerns about Irregular Menstrual Cycles and Missing Periods - #46723

Hello, You’ve mentioned that this year your menstrual cycles became longer, your TSH was 9, and after starting Eltroxin 25 mcg for 3 months, your cycles became regular with mild PMS. You also tried Shatavari and Neem tablets for acne. Now you’ve missed two cycles, although inflammation symptoms have improved.

Missing periods for 2 months is new for you and needs careful evaluation, especially in the context of thyroid, herbal supplements, and recent dietary changes.

🔎 Likely Reasons Thyroid imbalance (Hypothyroidism) • Even on Eltroxin, dose adjustment may be needed if TSH is still above target. Herbal influence • Shatavari may mildly support cycles, but Neem can sometimes affect hormonal balance when taken in tablet form. Recent dietary changes or stress • Sudden changes in fluids (coconut water, watermelon) usually don’t stop periods, but combined stress or imbalance can influence hormones.

🔎 Recommended Investigations TSH, Free T4 – to check current thyroid control Prolactin – to rule out hormonal interference FSH, LH – if thyroid is normal and cycles remain absent Pelvic ultrasound – to rule out structural issues (ovarian cyst, endometrium thickness)

🌿 Ayurvedic Supportive Medicines (Only after ruling out serious causes with investigations) 1.Shatavari Churna / Tablets – ½–1 tsp or 1 tablet at bedtime with milk 2.Ashokarishta – 15 ml + equal water after meals 3.Nishamalaki Churna – ½ tsp with warm water after dinner

🥗 Diet & Lifestyle ✅ Include Warm, freshly cooked meals Milk, ghee, soaked almonds or cashews Seasonal fruits (moderate quantity) Light exercise / yoga Relaxation / meditation to reduce stress ❌ Avoid Excess cold drinks or juices in large amounts Excess raw salads if digestion is weak Overuse of strong herbal supplements without supervision

🧘🏻‍♀️ Yoga & Physical Practices Sarvangasana / Viparita Karani – improves pelvic circulation Baddha Konasana / Supta Baddha – supports hormonal balance Gentle stretching for neck & shoulders to manage residual inflammation

🕉️ Follow-up & Expectations Recheck TSH & hormones in 2–3 weeks If TSH is high, Eltroxin dose adjustment may be needed Mild herbal support and balanced diet can help resume cycles naturally If periods don’t return after 1 month post-investigation, consult gynecologist for evaluation

✨ Missing periods for the first time is a signal, not a permanent problem. With proper thyroid control and supportive care, cycles usually normalize.

With kind regards, Dr. Sumi MS (Ayu)

Hlo,

Thank you for sharing all the details. Let’s break this down carefully. You have a few key points here: - History of hypothyroidism – Your TSH was 9.5, which is high, and you started Eltroxin 25 mcg. After 3 months, cycles improved, but PMS inflammation persisted. - Recent interventions – Coconut water, watermelon, shatavari, and neem. - New issue – Missed periods for 2 consecutive months, which is unusual for you. No other symptoms like weight changes, hair loss, or hot flashes.

Possible Causes of Missed Periods - Thyroid-related Hypothyroidism itself can cause menstrual irregularities. You just started thyroid hormone replacement; it may take a few months for TSH and thyroid hormones to stabilize. Sometimes, cycles can be skipped in the early months of treatment.

- Stress / lifestyle factors Even with regular exercise, stress or sudden dietary changes (like high-water-content diets or herbal supplements) can temporarily alter cycles. Supplements

- Shatavari can influence hormone balance and sometimes delay or regulate cycles.

- Neem generally doesn’t affect menstruation significantly, but combined effects can’t be ruled out.

- Pregnancy Always important to rule out pregnancy with a urine test if sexually active.

- Other hormonal issues Polycystic ovary syndrome (PCOS) Pituitary issues (rare, especially if you have no other symptoms)

Immediate Next Steps - Rule out pregnancy with a urine or blood test. - Check thyroid levels again – TSH, free T4, maybe free T3, especially since you are on a new dose. - Track your cycle – Keep a record of periods, any spotting, or other symptoms. - Hold off on herbal supplements until you consult your doctor, as they can affect hormones. - Follow up with your gynecologist or endocrinologist if periods do not return within a few weeks after the above checks. 💡 Key point: Since you’ve had hypothyroidism and recently started treatment, a 1–2 month missed period can happen, but it needs monitoring. If periods do not resume in the next month, or you experience symptoms like severe fatigue, weight changes, or unusual hair growth, you should see a doctor urgently.

If you want, I can outline a simple monitoring plan for the next 4–6 weeks to help figure out what’s causing the missed periods. This can help you avoid unnecessary panic while still being safe. Do you want me to do that?

YOUR TSH OF 9.5 SHOWS CLEAR HYPOTHYROID TENDENCY AND THAT ALONE CAN CAUSE LONGER CYCLES OR MISSED PERIODS EVEN IF EARLIER YOUR CYCLES WERE REGULAR. WHEN YOU STARTED ELTROXIN AND YOUR TSH CAME DOWN YOUR PERIODS BECAME REGULAR AGAIN WHICH CONFIRMS THAT YOUR MENSTRUAL CYCLE IS VERY SENSITIVE TO THYROID CHANGES

NOW COMING TO WHAT HAPPENED NEXT. TAKING COCONUT WATER AND WATERMELON DAILY FOR MANY DAYS HAS A STRONG COOLING AND KAPHA INCREASING EFFECT. ON TOP OF THAT SHATAVARI IS A COOLING AND NOURISHING HERB AND NEEM IS DRY AND COOLING. THIS COMBINATION CAN REDUCE INFLAMMATION BUT IT CAN ALSO SLOW DOWN OVULATION AND SUPPRESS MENSTRUAL FLOW IN SOME WOMEN ESPECIALLY IF THERE IS ALREADY THYROID WEAKNESS

SO WHAT YOU ARE EXPERIENCING IS NOT DANGEROUS BUT IT IS A SIGNAL THAT YOUR SYSTEM HAS GONE TOO MUCH TOWARDS COOLING AND HORMONAL SUPPRESSION. THAT IS WHY INFLAMMATION FEELS BETTER BUT PERIODS HAVE STOPPED

MISSING PERIODS FOR TWO MONTHS IN THIS CONTEXT DOES NOT MEAN PERMANENT PROBLEM BUT IT SHOULD NOT BE IGNORED

WHAT I WOULD ADVISE

FIRST CONTINUE YOUR ELTROXIN AS ADVISED BY YOUR PHYSICIAN AND GET YOUR TSH RECHECKED NOW. EVEN A SLIGHT RISE AGAIN CAN AFFECT PERIODS

STOP DAILY COCONUT WATER AND WATERMELON FOR NOW. YOU CAN TAKE THEM OCCASIONALLY BUT NOT DAILY

STOP NEEM AND SHATAVARI TEMPORARILY. THEY ARE NOT NEEDED AT THIS MOMENT

FOCUS ON WARM COOKED FOOD. ADD A LITTLE GHEE DAILY IF DIGESTION IS GOOD. AVOID RAW SALADS AT NIGHT AND EXCESS COLD FOODS

FOR SUPPORTING PERIODS AND HORMONAL FLOW YOU CAN USE GENTLE HEAT AND MOVEMENT. LIGHT WALKING SUN EXPOSURE AND WARM WATER BATHS HELP

IF PERIODS DO NOT RETURN WITHIN ONE MORE MONTH THEN AYURVEDIC SUPPORT LIKE RAJAPRAVARTINI VATI OR ASHOKA BASED FORMULATIONS MAY BE NEEDED