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March 25, 2002

Puberty

Question from Charlotte, North Carolina, USA:

My 13 year old daughter, who has had type 1 diabetes for about three months, started her monthly period for the first time about five months before diagnosis, and approximately two months later, she had another. Both times was very light, mostly just spotty for a week each, but she hasn't had another period since. I've heard that sometimes the disease caused her pancreas to stop working is the same thing that can effect other organs as well. Should I be concerned that her irregularity may be coming from her diabetes? Is this just normal at her age? What can you tell me about this? Is there a test that can tell if she has this disease?

Answer:

The most probable causes for the interruption of your daughter’s menses are likely to be either the stress of developing diabetes or to having been in not very good control or to a combination of these two. Another possibility is she has autoimmune hypothyroidism which is a common accompaniment to this form of diabetes in the Autoimmune Polyglandular Syndrome Type II.

I think it would make sense to ask her doctor about getting a TSH test, which is often done routinely anyway, to exclude this possibility. There are of course other conditions that might have caused this problem, but in the circumstances I think it best to wait for a few months before investigating further and in the meantime to make every effort at good blood sugar control.

DOB

[Editor’s comment: In is not at all unusual to see this kind of menstrual irregularity for about a year after onset of menses.

SS]