Irregular Menstrual Cycles

Irregular Menstrual Cycles

A change in your menstrual pattern is usually the first sign of menopause. During the time referred to as perimenopause, which for some women can last as long as 5 or even 10 years, the menstrual cycle is likely to become less predictable. Some women notice changes as early as their late 30s.
Because the decline of ovarian function occurs gradually, only 10 to 15 percent of women experience an abrupt cessation of menstruation. During this time, women whose periods do stop abruptly are apt to get a pregnancy test. It's important to note that pregnancy can occur, even amidst irregular cycles, so to ensure greatest accuracy, a blood test is recommended over standard urine tests.
For most women the change is more gradual, with a steady decrease in both the amount and duration of menstrual flow, until it eventually ceases to occur. Typically, the transition takes about four years. During this time, it may become difficult to keep track of your menstrual cycles, with periods occurring late or early, cycles being skipped, and the flow becoming heavier or lighter than previously experienced. This unpredictability is usually the biggest inconvenience of irregular cycles.
Irregular and longer cycles occur as hormonal regulators become less reliable. As menopause nears, the periods become further apart and the flow becomes lighter. If menstruation doesn't occur for 6 months to a year, menopause probably has occurred. If you have vaginal bleeding after a prolonged lack of menses you should see your doctor; it could be a sign of disease.
More frequent or heavier bleeding may also be experienced during the menopausal years. This occurs when estrogen continues to stimulate the uterine lining, while production of the progesterone needed to counteract its growth declines. Thus, when the lining is shed, the flow is much heavier than usual. Cigarette smoking and excessive alcohol intake can make a woman more susceptible to heavy irregular bleeding.
Declining ovulation may also shorten the menstrual cycle, so that periods come so close together that you bleed throughout the month. A 7 to 10 day menstrual period is not uncommon and bleeding between periods may also occur. Any unusual menstrual patterns should be evaluated by your doctor, to make sure they are truly due to changing hormone levels, rather than such conditions as fibroid tumors, polyps, uterine cancer, or cervical cancer.
To Stay In Control
Once medical problems are ruled out, the challenge for a woman with unpredictable menstrual patterns is to find ways of decreasing the inconvenience.
One method is to keep track of your cycles with an ongoing written record. This allows you to notice overall patterns in a system that seems to have gone completely awry. It also provides you with a record to bring to your doctor for evaluation. Making quick notes on your calendar may make the process less tedious.
To keep a log, note the beginning and end of your cycle, the type of flow, and when any accompanying symptoms, such as cramps, sore breasts, or bloating, occur. Also note bleeding that occurs at any time other than the end of your monthly cycle.
Even women who keep a chart, however, may still be taken by surprise by unexpected menstruation. Many women in this predicament find it helpful to continue to keep some form of sanitary protection handy at home, and in their purse.
If heavy bleeding becomes an ongoing problem, discuss the condition with your doctor. Depending on your individual case and where you are in the menopausal process, possible medical remedies include low dose birth control pills to regularize the menstrual cycle and reduce bleeding; progesterone therapy to cause regular monthly shedding of the uterine lining; and hormone replacement therapy. If the bleeding is associated with uterine fibroids (benign tumors), your doctor may recommend surgical removal of either the fibroids or the entire uterus (hysterectomy).