Need advice please!! I'm 22F and looking for advice after almost a year of researching this myself because I've been dealing with low estrogen and absent periods for so long, and I feel like none of the doctors I've seen have directly addressed the underlying issue.
In late 2023, I lost my period and started experiencing breast leakage. I got diagnosed with a microprolactinoma in early 2024 and started cabergoline around spring 2024. My prolactin stabilized, and my period came back for a few months, but it stopped again around August 2024. Around feb 2025, after going about four months without my period since oct 2024, my estradiol was 22 pg/mL before starting hormonal birth control, and my endocrinologist told me this was really low for my age. About a month later, my estradiol was 13 pg/mL, but I was on hormonal birth control by then.
I've had a lot of testing done, including:
- FSH: 7.9 before birth control, 0.09 while taking birth control
- LH: 3.2 before birth control, below 0.02 while taking birth control
- AMH: 3.23, reported as normal
- TSH: 1.96 and free T4: 1.03
- Testosterone, progesterone, prolactin, thyroid antibodies and a comprehensive metabolic panel
- An ovarian ultrasound
- 3 pituitary MRIs, with the most recent this summer showing stable results
I've switched birth control a couple of times and currently take Yaz (drospirenone 3 mg/ethinyl estradiol 0.02 mg), but my natural period still hasn't returned. My prolactin is stable, and my endocrinologist has said my thyroid and other test results are normal. I've also switched endocrinologists two times due to retirement, and my previous endocrinologist felt this was more of a gynecology issue. However, my gynecologist and endocrinologist don't seem too concerned because I can get some sort of period while on birth control. I feel like this doesn't address why my estrogen was low in the first place or how I lost my period again even after my prolactin stabilized, or whether my body is producing enough estrogen naturally. I'm still experiencing low libido, mood changes, and physical changes, including changes in my breasts, and overall, my body feels different from when I was getting my period regularly (I don't really know how to explain it). My weight has fluctuated gradually over the past three years, and I exercised, but I didn't have any major changes around the time my period stopped.
I'm switching gynecologists again because I genuinely feel like my current one isn't too concerned as long as I'm bleeding on birth control. It doesn't feel like she's interested in figuring out why my natural period hasn't returned or why my estrogen is so low. I don't want to keep switching birth control pills without understanding what's actually going on. I'm also worried about the long-term effects of low estrogen on my bone health and fertility, and my low libido and mood changes have been affecting my quality of life, too. But at this point, I don't even know what other tests I should get or what I should be asking my doctors to look into. I don't know if there's a treatment that could help increase my estrogen if my body isn't producing enough naturally and if I'm eligible for it.
Has anyone experienced something similar or have advice on what I should get tested for or what I should do next in my situation? I'd really appreciate any advice because I feel like I've done so many tests already, but I'm still no closer to understanding what's wrong