ABC’s of Menopause: Irregular Periods

Menopause is the “gift” that keeps on giving. With 34 associated symptoms that can easily be ascribed to a myriad of other health conditions, it can be impossible to know if what you’re experiencing is tied to menopause without a hormone test. Each week this series will break down symptoms to empower women to take back control of their health and enjoy some relief.

After years of paying the "Tampon Tax," one might expect that a skipped period during perimenopause would be a momentous occasion. However, even though pregnancy is somewhat unlikely during perimenopause, the unpredictability can still bring about anxiety associated with an unplanned surprise. As periods become more erratic in the initial phase of menopause—coming sooner, later, or becoming heavier—here's what you need to know.

What Causes Irregular Periods for Menopausal Women?

Hormonal fluctuations, particularly  in estrogenand  progesterone, play a central role in the occurrence of irregular periods during perimenopause. These hormones work together to regulate the ovulation cycles, so  the changing hormonal landscape disrupts the regular menstrual cycle, leading to unpredictable patterns, including skipped periods, heavier or lighter flows, and varying menstrual cycle lengths.

How Do I Know If My Irregular Periods Are Menopause Related?

Women within the typical menopause age range are more likely to experience irregular periods as a part of the natural transition. However, the only way to know for certain if irregular periods are menopause-related is to have your hormones tested and speak with a healthcare professional. 

What Else Causes Irregular Periods?

There are several other factors that can contribute to inconsistent or missed periods including:

• Pregnancy: Studies indicate that between ages 40 and 44, 10-20% of individuals engaging in regular unprotected sex will become pregnant within one year. This percentage increases to approximately 12% for those between ages 45 and 49. 
• Stress: Emotional and psychological stressors can disrupt the regularity of menstrual cycles.
• Underlying Medical Conditions: Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders may impact menstrual regularity.
• Extreme Weight Changes: Significant weight loss or gain can influence hormonal balance and menstrual patterns.
• Medications: Certain medications, including contraceptives and anticoagulants, may affect menstrual cycles.
• Cancer: Abnormal vaginal bleeding or discharge can be a sign of several gynecologic cancers.

What Are My Treatment Options?

Women should consult with a healthcare professional to rule out underlying medical conditions and discuss menopausal symptoms. Bioidentical hormone replacement therapy (BHRT) is the primary method that can help regulate hormonal imbalances, reducing the severity of irregular periods. Lifestyle modifications like stress-reducing practices, maintaining a healthy weight, eating a well-balanced diet, and engaging in regular physical activity can also help.

When Should I See A Doctor?

Painful and concerning irregular periods that significantly impact daily life should be discussed with a medical professional. If menopause is suspected, consultation with a hormone specialist regarding the comprehensive health benefits of an HRT program is recommended.

Conclusion

Pregnancy during perimenopause isn't a common occurrence, but it remains possible due to ongoing egg release from the ovaries in this phase. Despite being in the appropriate age range and undergoing menopausal symptoms, a woman can remain fertile. Equipping yourself with knowledge about the diverse symptoms empowers you to navigate it with greater awareness and ensure a more anxiety-free and well-informed journey.

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