Hello doctor, I am 34 years old. I am concerned about my absence of menses. My last menses was on the 16th of previous month which was about a week earlier than the before periods. I was diagnosed with autoimmune hepatitis and under medication of steroid 10 mg (prescription attached). Now I am completely normal and my last LFT test was completely under the limit. Please inform me whether the delay of menses is due to the side effect of steroids or due to other reasons. Is it a serious worrying issue?
Hello. I have gone through your history and also saw the prescription you uploaded of your recent visit to your hepatologist/gastroenterologist. (attachment removed to protect patient identity).  As I can see from the prescription he had asked you to continue the medications you were taking for autoimmune hepatitis which includes immunosuppressants like steroids (Omnacortil) and Azathioprine. Let me tell you that chronic steroids therapy can hamper with your menstrual cycles by disturbing the regulatory hypothalamo-pituitary-ovarian axis. So what I mean is it is common to have disturbed cycles when you are on chronic steroid therapy. So most likely that is the cause for delayed cycles, as I see even your thyroid level (TSH) appears to be within the normal range, (although close to the higher side of normal range). Please do not worry or panic as there is nothing grossly serious to worry about. As of now you will most likely be requiring this treatment and will take some time to wean off from these medications as they are more important medication, saving your life from redevelopment of autoimmune hepatitis. So, please continue these medications as advised by your gastroenterologist. Cycles should mostly resume or get regularized once you are slowly taken off from the steroids. Steroids therapy for autoimmune hepatitis (presently on Omnacortil 10 mg daily). Serum Prolactin levels. Continue vitamin D3 supplements as advised. Continue Omnacortil, Azoran, Folvite. Follow up with your endocrinologist as advised.