Do you have irregular periods? The typical menstrual cycle
is 28 days with bleeding that lasts from 4 to 8 days. If your period is
shorter, longer, or spottier than the average, take a look at the most common
culprits behind your not-so-regular cycle and what you can do about them.
Are You in Perimenopause?
Before you brush off this explanation based on your age,
perimenopause can start as early as your mid-30s. Perimenopause is the time
before menopause and can start anywhere from a woman's 30s to her 50s. Women in
this transitional stage still have their period - but the frequency, duration,
and symptoms of menstruation may change.
Hormonal changes affect ovulation and will change the perimenopausal
woman's cycle. Periods during perimenopause may be shorter, longer, lighter,
heavier, or unpredictable. You may not get a period one month and have what
seems like two the next. Even though you may not menstruate every month,
menopause won't start until you've gone a full 12 months in a row without a
period.
If you think perimenopause is the cause of your irregular
periods:
- Contact
your gynecologist. Even though perimenopause is a common cause for
irregular cycles in women over 40, it isn't the only possibility. Before
you assume perimenopause is at fault, get a doctor's diagnosis.
- Track
your periods. Are your periods really different than before? Track
your cycle on a calendar or in a menstruation app.
- Note
other symptoms. While you may not experience every symptom of
perimenopause, other signs include hot flashes, sleep disturbances, mood
changes, cholesterol level changes, bone loss, sexual changes, bladder
issues, and decreased fertility.
What can you do about perimenopause? If the doctor determines
you are in perimenopause, you have several options (such as hormone therapy or
antidepressants) to discuss.
Do You Have Uterine Fibroids?
These noncancerous growths can suddenly appear during a
woman's childbearing years. Fibroids can range in size from almost
imperceptible to large enough to change the entire shape of the uterus. Even
though they have the appearance of tumors, fibroids rarely indicate cancer of
the uterus.
Unlike perimenopause-related cycle changes, women with
fibroids typically won't experience shorter, lighter, or missed periods.
Instead, fibroids may cause:
- Longer
periods. Your period may last more than the typical seven days. This
can result in less time between periods or longer, but fewer, periods in a
year.
- Heavier
periods. Women with fibroids often experience heavier period bleeding.
- Increased
pain or pressure. While many women experience little to no discomfort,
fibroids can increase menstrual cramping or cause pelvic pain.
If you're not sure whether fibroids are the cause of your
irregular periods, contact your doctor. The doctor will perform a pelvic exam
and an ultrasound (or other imaging tests) to diagnose this issue. Some small,
symptomless fibroids require no treatment. Larger or painful fibroid treatment
may include hormonal therapy medications or IUD, MRI-guided surgery, ablation,
myomectomy, or surgery.
Do You Have Endometriosis?
Endometriosis is an often painful condition where the
uterine lining (endometrium) grows outside of the uterus. While it can (rarely)
spread beyond the pelvic organs, endometriosis typically affects the pelvic
lining, fallopian tubes, and ovaries.
Along with pain during intercourse, fatigue, and
infertility, endometriosis can cause:
- Longer
periods. Endometriosis can cause a thickening of the uterine lining.
The thicker lining takes longer to shed and may increase the overall
length of each period.
- Irregular
periods. Longer periods may throw off the normal 28-day cycle. This
leads to shorter cycles with less time in between periods.
- Menstrual
or ovulation pain. Women with this condition may experience increased
menstrual cramping or pain with ovulation.
Like perimenopause and fibroids, endometriosis requires a
doctor's diagnosis. If the doctor does diagnose you with endometriosis,
treatment options may include pain medications, hormone therapy, or surgery.
Are your irregular periods getting in the way of your
everyday life? Contact the office of Jack
G. Faup M.D.
for more information.
