What Causes Irregular Periods When Approaching Menopause
As menopause approaches, periods can become lighter, heavier, and more sporadic in timing due to drastic fluctuations of key reproductive hormones, specifically estrogen and progesterone.
Throughout women’s reproductive lives, estrogen and progesterone drive the regularity of the menstrual cycle. As such, when their production wanes as the hormones’ main producer – the ovarian follicles – begin to run out, irregular periods ensue.
Moreover, there are other contributing factors that can cause missed periods. Stress, sleeping disorders, fatigue, diet, excessive or insufficient weight, and other environmental elements can influence menstrual cycles. It’s important to remember that the mind and the body are intertwined and can affect one another.
Other Causes For Period Changes
The regular monthly period is not the only reason why people may bleed.
Because a persons periods are often irregular during perimenopause, they should pay extra attention for any abnormal symptoms particularly as some uterus-related conditions are more common during and after perimenopause.
People may bleed because of:
- Endometrial atrophy. Low estrogen in perimenopause and menopause can cause the tissue of the uterus to get very thin, which can cause irregular bleeding.
- Uterine polyps. These are benign growths that can grow inside the uterus and cervix. Polyps do not always cause symptoms, but some people notice bleeding after sex.
- Endometrial hyperplasia. Hormonal shifts can cause the lining of the uterus to thicken in perimenopause. When the body has too much estrogen without enough progesterone, this thickness may cause bleeding. Bleeding is its most common symptom. Endometrial hyperplasia is treatable but can increase a persons risk of cancer.
- Uterine Cancer. Uterine cancer happens when abnormal or atypical cells progress into cancer. Though rare, it generally presents with heavy bleeding or postmenopausal bleeding.
Perimenopause is not a disease and does not require treatment. It can, however, increase peoples risk of developing certain diseases. Moreover, the menstrual cycle can change for reasons other than perimenopause.
Anyone experiencing changes in their menstrual cycle should see a doctor for a diagnosis.
When To Seek Help
Dont ignore a long period. Its important to see your doctor to discuss why you might be experiencing this symptom. Delaying your diagnosis and treatment could lead to a worsening of the underlying condition responsible for the extended bleeding.
You may want to seek immediate care with a long period if you spike a fever or are losing an abnormally heavy amount of blood or large blood clots. A sign that youre losing a lot of blood is if you need to change a pad or tampon one to two times per hour for several hours. You may also begin to feel lightheaded if youre losing a lot of blood.
There are many causes for a long period, so your doctor will likely begin your appointment by asking you some questions. These may include:
- when your period started
- how many pads and tampons youve used in the last day
- your sexual activity
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What To Do If You Have A Missed Period For 2 Months
If you miss your period for 2 months in a row, you should connect with your doctor to see if everything is okay. You can also try a few things at home first:
1. Take a Pregnancy Test
After the first month passes, take a home pregnancy test when you are around two weeks late for your period. You can buy these online or at any drugstore. If the test is positive, give your doctor a call for confirmation. If the test is negative, give it a few more weeks then re-test.
2. Change Your Lifestyle
Have you started a new birth control method? Are you under a lot of stress? Have you lost or gained weight? One of the above causes may be the issue and you may be able to make some changes in your lifestyle that will help balance your cycles.
3. Call Your Doctor
If you don’t have a period after two or three months, you need to call your doctor. Going longer than two months is abnormal and you will need to be evaluated. The doctor will diagnose the cause and you may need medical treatment.
You Have Thyroid Issues
One in eight women will suffer from low thyroid function, or hypothyroidism, at some point in their lives, according to the OWH.
Your thyroid is a little butterfly-shaped gland that controls the hormones that regulate many systems in your body, including how fast you burn calories, how fast your heart beats, and yes, menstruation. Having too little thyroid hormone can cause your period to be super long and heavy, the OWH explains.
Other symptoms of hypothyroidism include weight gain, fatigue, and hair loss, so if you’re experiencing any of those, along with longer-than-normal periods, bring it up to your doctor, says Dr. Ross.
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Uterine Polyps Or Cervical Polyps
Uterine polyps can be the cause of your prolonged menstrual flow. These are masses attached to the wall of the uterus and can sometimes extend down into the cervix. They cause irregular spotting between periods and can be visualized with a hysteroscope or ultrasound.
Uterine polyps are a common cause of bleeding after menopause. If you are below 4o years, then you may have pain and prolonged periods.
If your doctor finds uterine polyps as the cause of your prolonged periods, a D& C will be advised.
Symptoms Of Abnormal Uterine Bleeding
- bleeding for more than eight days
- heavy blood loss during the menstrual period for example, soaking through one or more sanitary pads or tampons every hour for several hours in a row
- needing to change your pad or tampon during the night
- have to change or restrict your daily activities due to your heavy bleeding
- bleeding or spotting between periods
- cramping and pain in the lower abdomen
- any vaginal bleeding after menopause.
If you think you may be experiencing heavy menstrual bleeding, you may find it useful to keep a pictorial blood loss assessment chart this can help you give your doctor an idea of how heavy your period is.
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What Is Prolonged Period
Women period is due to endometrial shredding that occurs during your menstrual cycle. It occurs due to the interplay of many hormones like estrogen and progesterone.
If your period lasts between two and seven days, then its normal. Women can have periods that last for three days or longer periods that last up to six to seven days. This is normal.
However, any menstrual blood flow more than seven days is considered abnormal.
Period blood flow more than seven days is prolonged and requires urgent treatment. Long periods, in women of reproductive age, can prevent pregnancy or cause infertility.
What Is Heavy Menstrual Bleeding
Heavy menstrual bleeding, previously called menorrhagia, is abnormally heavy or prolonged menstrual bleeding. Heavy menstrual bleeding is a common complaint andaccording to the American College of Obstetricians and Gynecologists, one in three women seek treatment for it. Despite its many sufferers, heavy menstrual bleeding can be a sign of a serious medical condition.
You can determine if your periods are unusually heavy if you are soaking a pad or tampon in less than two hours or passing clots larger than the size of a quarter. Your bleeding is considered prolonged if it lasts longer than seven days. It is also considered heavy if you need to change your pad or tampon overnight or need to wear more than one pad at a time to control the flow.
Prolonged, heavy bleeding can impact both your quality of life and your health. Women may find it difficult to live their daily lives normally as they may be constantly visiting the washroom or worried about leakage.Prolonged, heavy bleeding may lead to anemia, which is a blood disorder characterized by not having enough healthy red blood cells. Anemia can be mild without any symptoms or can cause you to feel dizzy or weak, cause breathing problems, heart issues and lead to further health issues.
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You Have An Underlying Blood Disorder
It’s rare, but it’s possible that extra-long periods are a sign of an underlying illness, like a hematologic disease, says Dr. Toth. Some of the underlying diseases associated with bleeding, like hemophilia or Von Willebrand disease, are genetic, so if you have this you likely already know about it.
Still, if your periods are lasting a super-long time, and you’ve already been cleared for other conditions, it’s worth checking in with your doctor about tests to rule out a blood disorder that you might not be aware of.
Two Periods In One Month: Are Multiple Periods A Reason To Worry
Normal menstrual cycles range from 21 to 35 days. However, its not uncommon to experience monthly variations in menstrual cycles. Some cycles may be shorter and others longer, which means its possible to have 2 periods in a month.
In most cases, getting a period twice a month has a simple explanation. If it happens repeatedly, however, its important to take notice of any signs and symptoms. Read on to learn why two periods may happen in the same month.
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Does A Missed Period For 2 Months Mean I’m Pregnant
When you are pregnant, your menstrual periods will stop. However, a missed period doesn’t always mean you’re pregnant. If you’re wondering whether you might be pregnant, there are a few points that point to a possible pregnancy. These include:
- You were actively trying to get pregnant in the months before.
- You ovulated prior to your period’s stopping.
- You had sexual intercourse in the ovulation window .
- You were sexually active and not using birth control.
If all of the above points are true, then you have a good chance of being pregnant.
Signs of Early Pregnancy
The only way to truly know if you’re pregnant is a positive pregnancy test and confirmation by a doctor. However, there are a few signs that may give clues to a possible pregnancy. If a missed period for 2 months is due to pregnancy, you’ll start feeling the symptoms below around the four-week mark. Some women even notice subtle changes sooner than four-weeks.
- Breast tenderness
- Breast fullness
- Lower abdominal bloating and fullness
- Feeling short of breath with exercise
- Sensitive to smells
- Feeling tired all the time
- Needing to urinate more often
- Higher than normal body temperature
Being Overweight Or Obese
Being overweight or obese can also affect your menstrual cycle. If you’re overweight, your body may produce an excess amount of oestrogen, one of the hormones that regulate the reproductive system in women.
The excess oestrogen can affect how often you have periods, and can also cause your periods to stop. Your GP may refer you to a dietitian if you have a BMI of 30 or more, and it’s affecting your periods. The dietitian will be able to advise you about losing weight safely.
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You Have Pelvic Inflammatory Disease
Pelvic inflammatory disease is a condition caused by sexually transmitted bacteria, like that from gonorrhea and chlamydia, traveling from the cervix into the fallopian tube. PID can cause bleeding that is heavier than normal, spotting between menstrual cycles or spotting after sex.
If you have abnormal bleeding and pain, get a pelvic exam and get tested for sexually transmitted infections, says Dr. Horton. They can be treated with medication, which will stop the progression of PID too. Left untreated though, and PID can cause lasting issues with fertility.
Skipping Or Discontinuing Birth Control
Birth control pills suppress your normal menstrual cycle with hormones that prevent ovulation. The pills usually come in a three-week supply followed by a week of placebos , and the lack of hormones during the placebo week is what makes you have a period.
When you go off of the pill, or even miss just a pill or two, your body may react like it does during the placebo week and start shedding the uterine lining. This can happen even if it hasn’t been very long since your last period. A similar process happens if you make a mistake with a birth control patch or ring.
The proper way to resume your birth control after missing one or more doses varies by type, so be sure to read the information that comes with your contraceptive or ask your doctor or pharmacist what to do. And don’t forget that you may need a backup method of contraception or emergency contraception to avoid an unintended pregnancy.
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You’re Being Exposed To Environmental Estrogens
Long periods typically occur due to a dominance of estrogen over progesterone in the body, explains physician Lorraine Maita, M.D. But estrogens outside your body, like those found in plastics, pesticides, and meat with added hormones, can have the same effect. To curb the effects of environmental estrogens, eat a diet high in fiber, which prevents excess estrogen from being absorbed, and go for produce without pesticides and hormone-free and antibiotic-free meat and dairy when possible.
If you’re still wondering, Why is my period so damn long? Dr. Maita recommends downloading a period-tracking app so you’re aware of what’s normal for you. If you spot anything off, it’s most likely not a serious problem, but it still can’t hurt to get it checked out. Even if there’s no underlying issue, the blood loss can leads to anemia or exhaustion, says Dr. Ross, so it’s important to make whatever adjustments are necessary.
The Normal Menstrual Cycle
Ovulation is the release of an egg that’s ready for fertilization. Ovulation typically happens 11 to 21 days after you start bleeding from a period .
Getting your period every 28 days is considered “normal,” but that’s really just an average, not the rule. Normal menstrual cycles actually last anywhere from 21 to about 35 days. Some woman naturally have very short cycles and some even bleed during ovulation. However, ovulation-related bleeding should be just a bit of spotting.
While most women have a regular cycle they can rely on, some have irregular periods for their entire lives.
Your period frequency, how many days it lasts, and how much you bleed is influenced by your body’s current hormone levels. Hormones fluctuate, especially during adolescence and before menopause. Some medical disorders and certain lifestyle factors also affect menstruation. These things can make you have more frequent periods or give you an occasional early period. Factors that could be at play include:
- Lifestyle changes
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