12 May 2016
Help! Why Are My Periods So Irregular?
One of the most common questions I’m asked in the Hormone Harmony Club is “what is going on with my period!?”
These women are experiencing flooding, clots, short cycles, abnormally long periods, cramping and symptoms that are alarming, and in some case, life-altering.
Irregular periods are often one of the first signs that a woman is entering perimenopause. The exact symptoms of irregular periods vary depending on a woman’s unique cycle. Most women experience irregular periods for three to ten years before periods stop completely.
For most women, the average cycle length is 25-31 days with bleeding that lasts about 5 days. Irregular periods are defined as changes in this typical cycle and are characterized by abnormal bleeding and/or unusual cycle lengths.
Causes of Irregular Periods
For women approaching menopause, the most likely cause is fluctuating hormonal levels. The menstrual cycle is controlled by estrogen and progesterone, both of which begin to decline in a woman’s 40’s and 50’s. When hormone production begins to taper off, periods begin to vary in length and bleeding amount.
Estrogen. Estrogen is responsible for thickening the uterine lining before ovulation. As levels of estrogen become erratic in menopause, this lining is often shed irregularly and can lead to heavy bleeding, clots and variation in cycle length.
Progesterone. Progesterone is responsible for triggering the shed of the uterine contents after ovulation when fertilization hasn’t occurred. It is also responsible for controlling the intensity and duration of menstrual bleeding. In months where no egg is released, progesterone is not produced. This can lead to build up of the uterine lining and estrogen dominance. When the lining does shed in this situation, bleeding can be very heavy and prolonged.
Can I Still Get Pregnant?
Many women wonder about their fertility when they begin to experience irregular periods. It is important to remember that pregnancy can occur anytime before menopause, even if a woman’s periods are irregular. It is not uncommon during perimenopause to go months without a period, only to have it return. During this time, it is still possible to become pregnant.
How to Manage Irregular Periods
A three-tiered approach can be used to manage bothersome symptoms. I generally recommend using lifestyle changes and supplements together before moving to surgical options.
1. Lifestyle changes.
Lifestyle changes can help with irregular periods. Leading a sedentary lifestyle or consuming too much caffeine or alcohol can exacerbate symptoms. Increased stress can also increase the severity of irregular periods. Stress-relief techniques such as yoga or meditation can be helpful for this.
Some simple dietary changes can also be helpful. Increasing the intake of complex carbohydrates, fruits, vegetables, fiber and water can help balance the hormones.
Avoid foods and products that contain xenoestrogens such as soy, plastics, pesticides and cosmetics because they can alter estrogen levels.
Supplements that target improvement of the progesterone/estrogen ratio can be helpful for managing symptoms like flooding, cramps and clotting. Chasteberry is one supplement that is helpful, however, it is less effective the closer a woman is to menopause. Bio-identical progesterone supplementation can also be very effective for heavy or prolonged bleeding. The goal is not necessarily to completely normalize cycles, but to control symptoms that affect quality of life.
DIM (diindolylmethane) or IC3 (indole-3-carbinol), which are both created from compounds in cruciferous vegetables, help lower estrogen levels thus improving the balance of estrogen/progesterone.
Surgical alternatives such as hysterectomy or endometrial ablation are options for women who have tried other options without success.
When to See a Doctor
It is perfectly normal during perimenopause to have irregular periods. However, there are other conditions that can affect bleeding and warrant getting checked out. If you’ve tried some of the tips above with no success, it’s time to see your doctor.
Blood clotting issues, fibroids, pregnancy and occasionally cancer are some of the reasons that might cause abnormal bleeding. Any bleeding AFTER menopause should also be evaluated by your doctor.
Dr. Anna Garrett is a menopause expert and Doctor of Pharmacy. She helps women who are struggling with symptoms of perimenopause and menopause find natural hormone balancing solutions so they can rock their mojo through midlife and beyond. Her clients would tell you that her real gift is helping them reclaim parts of themselves they thought were gone forever.
Find out more about working with her at https://www.drannagarrett.com/work-with-me/.