Expert: Claes-Gustaf Nordquist, M.D. - 6/1/2009

Question
"for three years i have been having increasingly severe symptoms of a hormonal imbalance. i have had 4 periods in the last three years. originally it was diagnosed as being caused by riperdal and a high prolatin level when my gyno tested my hormones..he also stated my blood sugar was not terrible but not great. i was retested and blood sugar was completely normal..basic symptoms are weight gain especially in my stomach and upper body , face.. and a noticeable hump on my upper back right under my neck ..not really in my legs at all, increasing hair growth on face, absent periods, muscle weakness in legs, a complete lack of interest in sex.. the gyno has given me progestin twice to try to get my period to start and neither dose worked.. all my hormones have been retested and all are in normal range, the only one they did not test was cortisol..the prolatin level is also down and i have been off risperdal for quite a few months now..and obviously i am not pregnant..in march i was also diagnosed with catartacts i am only 45 and never been a prolonged course of steroids..both the gyno and the eye dr have recommended i seek the advice of a endocrinologist as my symptoms seem to indicate there may be a high cortisol level..as you may know risperdal has been linked to a high prolatin level and to the development of pituitary tumors.. but these are usually prolatin secreting not cortisol..my family physician is not convinced that i should even be tested for high cortisol.. he is a big believer in stress being the cause of nearly everything..and  i do know stress can cause high cortisol .. but my question is .. could stress cause it to actually be high enough to cause a period to stop for 11 months and cause cataracts? and should i seek a different dr who is willing to test the cortisol... i am quite aware that cushings .. which is what i have found to most closely correspond to my symptoms(including the cataracts) is extremely rare .. i am confused and not sure if i should drop it .. or try even harder to get an answer..?"  

Answer
Your question is actually to a large extent outside my area of expertise here and should be directed to an expert of endocrinology. However I think you should consult another dr.! While stress CAN cause long time menstrual disturbances I think your whole picture too serious to just assume that all of it is due to stress. Good luck!