Thursday, March 31, 2011

Irregular Periods during Menopause: Symptoms, Causes, and Treatment

Overview

In general, irregular periods are very common during the perimenopause. The most common early menstrual irregularity noticed in the perimenopause is a shortening of cycle length. Women with prior 28 day cycles will commonly describe 24 to 26 day cycles during the early perimenopause. Eventually, the cycle length widens and skipping menses typically occurs. These changes in cycle may lead to heavier flow in the early perimenopause, followed by a lighter flow and occasional spotting in the later perimenopause. A common reason for the late periods and prolonged bleeding is due to 'anovulation' (not releasing an egg). When this occurs, there is no signal to the body to cause a period (if there is no pregnancy). When this continues for long enough, the body starts to shed the uterine lining in a 'piece-meal' fashion, which leads to the prolonged bleeding. This can occur for long periods of time, or can correct itself by the next cycle. The unpredictable aspect of the perimenopause can be the most frustrating.

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Regular Periods

Before we can define an irregular period, we must first determine what a regular period is. People often say that a regular period occurs every 28 days, but actually, every woman's menstrual cycle is different. Depending on your body and your hormones, you may get your period every 20 days or your may get your period every 35 days. A good way to determine if your periods are regular is to keep a chart and count the number of days between each period. If they occur with roughly the same number of days between each cycle, then your periods are regular. A regular period typically lasts 5 days, but it is completely normal to menstruate for anywhere between 3 and 7 days.

Irregular Periods

Irregular periods aren't unusual they affect about 30% of women in their reproductive years. An irregular period is any type of bleeding that is abnormal when compared to your usual menstrual cycle. This can include a late period, an early period or bleeding between periods. It can also appear as particularly heavy bleeding (menorrhagia) or scanty bleeding. Many women also experience irregular periods in the form of a missed period, continuous periods, or periods that occur twice in one cycle.

Causes of Irregular Periods

Irregular menstrual periods are usually the result of hormonal signals that have been thrown out of sync. In order to produce a period, your body makes hormones, like estrogen and progesterone. These hormones are kept in the hypothalamus, pituitary gland, and ovaries inside your body. In order to trigger ovulation and menstruation, these parts of the body need to send signals to one another. Sometimes, these signals get crossed or skipped, causing irregular periods.

But what causes these hormone signals to get out of whack? Well, there are actually a number of things that can easily cause your hormone levels to change, other than the menopausal symptom. Among them:

  • Pregnancy: If you are pregnant, your body will begin producing different levels of hormones. This will cause numerous pregnancy symptoms, including an end to your period.
  • Stress: Stress is a common cause of irregular periods. If you are fatigued, worried, or anxious this can cause your hormones to become unbalanced.
  • Diet: A poor diet or extreme weight loss or gain can also affect your hormones. Women with anorexia or bulimia often have no period or irregular periods.
  • Exercise: Intense exercise can wreak havoc on your body, often causing irregular periods.
  • Menarche: the cycles after a girl's first period may be irregular for some time. It can take up to 3 years to get regular periods.
  • Hormonal Birth Control: Birth control pills and irregular periods sometimes go hand in hand. It can take a while for your body to adjust to the new levels of hormones delivered by hormonal birth control.
  • Travel.
  • Hormone problems. This may cause a change in the levels of the hormones that the body needs to support menstruation.
  • Illegal drug use.
  • Problems with the pelvic organs, such as imperforate hymen, polycystic ovary syndrome, or Asherman's syndrome.
  • Breast-feeding. Many women do not resume regular periods until they have completed breast-feeding.

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Complications

During the perimenopausal period, the most likely explanation for your irregular cycles is menopause. Perimenopause refers to the time before menopause when hormone levels, particularly estrogen, begin fluctuating. Perimenopause occurs, on average, about four years before actual menopause. Menopause is timed as the date of the final period, confirmed after periods have been missed for 12 months.

In the meantime, however, your hormones are all over the place. Some months, levels of estrogen and/or progesterone are up, and some months they're down. All of which affects your periods. You may go months with a normal period, or months with one that's so heavy you can't leave the house. Your period may last four days or two weeks. You may skip a month or have spotting between periods. You may find your period comes every 28 days or every 45 days. There just doesn't seem to be any rhyme or reason to it.

Perhaps the most bothersome part of all this is the heavy bleeding. It's not just a slight inconvenience. Heavy bleeding makes it difficult for women to leave their homes, sit in meetings, shop or exercise, because they fear having an "accident." Additionally, the fatigue that often accompanies heavy bleeding can interfere with your daily activities.

Plus, heavy bleeding can lead to iron-deficient anemia, the most common health-related threat of heavy bleeding. While most cases of anemia are easily treated with oral iron supplements, sometimes the bleeding is so severe a woman's entire volume of blood drops, leading to shortness of breath, severe fatigue and heart palpitations that require hospitalization.

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Treatment

As irregular periods during menopause are related to low estrogen levels, the best way to overcome irregular periods is dealing with hormonal imbalance. The major types of treatment options include lifestyle changes, alternative therapy, and medical procedures.


As a first step to get relief, women should make an effort to change easily controllable factors in their daily lives, such as diet and exercise. However, although lifestyle changes help to treat symptoms of hormonal imbalance, such as irregular periods, they don't correct the underlying problem. To attain maximum relief from irregular periods, menopausal women should seek an alternative treatment to help reverse estrogen decline and treat irregular periods at its source. As a last resort, a few women with severe conditions may find it necessary to consult their doctor about undergoing certain medical procedures. Keep reading below to learn about what each option for treating irregular periods entails.

Lifestyle Changes

Irregular periods caused by fatigue, stress, and poor physical health should be corrected by adopting a healthy lifestyle. This is the easiest, cheapest and safest way to alleviate menopause symptoms. Here are some tips:

• Enjoy a healthy diet: Abnormally long period cycles or absent menstruation are sometimes caused  by  poor  nutrition  and  lack  of adequate fat in the diet. Avoid crash dieting and extreme restriction, and eat a healthy, balanced diet.
• Be prepared: In the years leading up to menopause, menstruation may occur sporadically and at unexpected times. Always having a supply of sanitary napkins or tampons on hand can help.
• Reduce stress: Practicing stress reduction techniques like yoga, meditation, or aromatherapy can help to alleviate some of the uncomfortable symptoms associated with PMS, like headaches and irritability.

Alternative Medicine for Irregular Periods

Because lifestyle changes only treat the symptoms of hormonal imbalance, such as irregular periods, herbal supplements are a great solution for fixing the actual problem. Herbal remedies are typically cost-effective and free from serious health risks or side-effects.

The main types of herbs that are effective at treating menopausal symptoms include phytoestrogenic herbs, which have low levels of plant hormones that have an estrogenic affect in the human body, and non-estrogenic herbs, which encourage the body to increase its own hormone secretion.

Both of these herbs have been used to successfully treat hormonal imbalance. Phytoestrogenic herbs, however, have been criticized for their tendency to make the body less responsive to producing its own estrogen, thus worsening the problem. Non-estrogenic herbs, on the other hand, encourage the body to correct hormonal imbalance by itself.

In medical terminology, these plants are called "selective estrogen-receptor modulators" (SERMS). They don't just raise total levels of estrogen, but have the unique capacity to selectively increase estrogen in some organs, and block or reduce it in others. In a premenopausal woman suffering from elevated estrogen levels, for example, these herbs can decrease estrogen, while in a postmenopausal woman, they help to augment hormone levels. This herb thus balances hormone levels naturally.


An excellent example of a safe and effective non-estrogenic herbal supplement for hormonal imbalance is MacaActive. This herbal supplement is noteworthy for its ability to balance hormone levels in women by nourishing the hormonal glands, thus alleviating most disorders related to hormonal imbalance, including irregular periods.

Medical Procedures

After lifestyle changes and alternative therapy, medical procedures (especially hormone replacement therapy or surgical procedures like hysterectomy) are the most extreme treatment solution. Pharmaceutical companies driven by profit motives lobby hard to make women think that this is the only option for treating menopause symptoms, but in reality serious medical procedures are only appropriate for a very small percentage of women. Due to the elevated cost and associated side effects, including a higher risk for certain types of cancer, this step should only be considered as a last resort for women with severe conditions. Women who think this treatment may be appropriate for them should seek advice from their doctor.

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