It happens every 28 or so days like clockwork. Once a month, you know to stock up on tampons or pads and that you may require time alone with your hot water bottle or an extra nap. It’s your period, your reliable monthly friend (or foe).
Then, suddenly, your cycle becomes elusive and mysterious. You may start missing your period here and there, or what the heck, you get two periods a month. It may disappear for months and then come roaring back with a vengeance, only to vanish again. What’s the deal?
Friend, you may be in perimenopause.
What are irregular periods?
Our periods are never the same from month to month. They may be lighter or heavier, last longer or shorter.
There are times in your life where your period may not arrive on schedule. Has there ever been a teenager who didn’t unexpectedly get their period at the worst possible time? Mothers may remember when after giving birth the timing of their periods was out of whack. Other factors such as stress, disordered eating, the birth control we use, fibroids, and endometriosis can also affect our periods. Other factors such as thyroid disease, hormonal birth control and prolactinoma, can make your cycles more erratic.
But if you’re in your late 30s or early 40s, you may notice that your periods are starting to change. Your estrogen levels begin to drop. As you start to ovulate less, your cycle might get longer, so you may go longer stretches without a period, or you may bleed more or less. These irregular periods later in life are a sign of perimenopause.
Why do my periods become irregular during perimenopause?
About 90 percent of women will experience some changes in their bleeding patterns over the course of eight to ten years before they stop menstruating, according to The Menopause Book: The Complete Guide: Hormones, Hot Flashes, Health, Moods, Sleep, Sex by Barbara Kantrowitz and Pat Wingert.
Can you still get pregnant when your periods are irregular?
Yes, yes, you can. Unless you're ready for the possibility of an unexpected surprise, if your cycle is erratic and unpredictable, definitely consider staying on your birth control.
When should I talk to my doctor about irregular periods?
The best thing to do is to start keeping track of the situation. Write down how long your periods are, how heavy, when in your cycle you begin to experience cramping. If your periods halt without other symptoms, your doctor will likely want to do a workup.
If there’s a significant change, such as heavy bleeding where you’re going through pads or tampons every hour, clots, bleeding that lasts more than seven days, or bleeding during or after sex, talk to your doctor.
If, at any age, your periods are keeping you from living your life and doing your job, you should definitely talk to a healthcare professional about treatments or procedures that may help.
While irregular bleeding is a normal part of our hormonal transition, heavy bleeding isn’t always due to perimenopause. Your health provider can help you figure out if the bleeding is a result of other causes, such as cysts, polyps, fibroids, or certain cancers.
Come to your appointment with this information at the ready:
Flow. Your normal flow and any recent changes.
Frequency. The frequency of your periods and any recent changes, including spotting.
Pain. How much, when, and if there have been changes.
Medications. Come with a list of anything you’re currently taking, including supplements.
Life impact. If the bleeding or anything related to your periods is affecting your ability or desire to have sex, how you function in your career, or your daily life, be specific. The more you can tell your healthcare provider about your experience, the better they can figure out the cause and help you start to feel better.