In a message dated 95-09-13 18:18:54 EDT, you write:

>Subject: Frequent Periods/Elevated Cholesterol

Hello.I'm a pediatrician in the Cleveland area, and I often deal with
adolescents with frequent periods. The most common cause is anovulatory
bleeding, where the body doesn't produce the surge of progesterone necessary
to mature the lining of the uterus and the women then has bleeding that is
irregular and unpredictable. I also worry about  pregnancy, infections, and
lesions on the cervix, but  her pelvic/PAP  was normal. My rule of thumb is
that if the woman is not symptomatically anemic and the bleeding is not
dangerously heavy, she should take iron and wait. Usually it improves on its
own (I've waited for several months to a year). The irregular bleeding could
be due to the breast  feeding (some studies have suggested that breast
feeding women have anovulatory periods when their periods return) or it could
just be her body recovering from the hormonal changes of pregnancy or it
could be stress or it could be early menopause or it could be thyroid disease
or a few other things. I don't know why further testing couldn't be done now.
If it needed to be treated,  I would even try a few days of provera first
before suggesting weaning.

I don't deal much with high cholesterol in pediatrics,  but I did see a
reference to cholesterol levels in puberty, pregnancy, and lactation and my
impression was that normal levels are not known. Was it a fasting or a random
cholesterol and what is the rest of her lipid profile? Have they tried
dietary changes to lower it? I guess that it's easier to suggest weaning than
to suggest not smoking.

Mary Murphy MD
Cleveland, OH