Doctor Q & A: Irregular Periods and Menopause

Question: My periods are irregular. Does that mean I am going into menopause?

Irregular periods with text 300x199 Doctor Q & A: Irregular Periods and Menopause Photo

Is your period irregular? There are a number of possible causes.

Dr. Hales: When you start having irregular periods, you may have entered the phase of perimenopause, which is when hormones go through fluctuations. This does lead into menopause (where a person has no period for a full 12 months).

Additional symptoms include:

•    Hot flashes
•    Insomnia
•    Night sweats
•    Mood swings with anxiety and irritability
•    Depression
•    Vaginal dryness
•    Decreased libido
•    Painful intercourse

However, you need not panic that you have arrived at this phase of life, even if you are experiencing all of the above symptoms. There are other conditions that cause these. The most typical is a thyroid imbalance, which often mimics a perimenopausal state.

For that reason, blood work should be done to investigate the thyroid hormone levels as well as estrogen and progesterone levels. Likewise, a pituitary problem can also signal these symptoms and can be diagnosed with simple blood tests.

Other causes of irregular periods include:

•    Emotional stress. Emotional overload can block ovulation, causing lower levels of estrogen and wreaking havoc on cycles.

•    Illicit drugs. Many illicit drugs typically cause significant elevation of prolactin, a hormone released from the pituitary gland that makes the body think it’s pregnant when it’s not, causing an irregular cycle or lack of periods. Cocaine and heroine affect the body this way.

•    Medications. Antidepressants, contraceptives, and various hormones may also cause an elevation of prolactin.

•    Excessive alcohol. Getting drunk or imbibing to excess can change the menstrual patterns, delaying periods or shortening cycles at other times. It’s unpredictable.

•    Travel. Traveling, especially when it’s long-distance or to different time zones, may contribute to sleep deprivation, which can cause hormonal imbalances.

•    Significant weight gain or loss. If the body is at an unhealthy weight, it will naturally stop ovulating in order to prevent pregnancy until nutritional equilibrium is reached. This can cause an irregular cycle.

•    Eating disorders. Anorexia and bulimia nervosa lower estrogen levels, consequently delaying or stopping menstruation. Also, the nutritional deprivation leads to a failure in ovarian follicle development.

•    Increased exercise. Intense exercise interferes with menstrual cycle length by causing anovulation, or a halt to ovulation.

•    Hormonal imbalance. Dysfunction of the thyroid, pituitary, or adrenal glands can each cause irregular periods.

•    Polycystic ovaries. This is a condition where there is a high estrogen level, but irregular or no periods because the egg follicles are growing but not being released.

So, while it is possible that you are heading toward your “change of life,” keep in mind that it might simply be a hormonal imbalance or temporary medical condition which can be corrected.

Seek a consultation with your gynecologist or family physician. Your cycle and issues will be discussed and evaluated thoroughly to get you on the road to a healthy, symptom-free life.

Barbara Hales, M.D. helps people improve their health and navigate the healthcare system of today. After working as a physician in women’s health and surgery for thirty years, she now focuses on helping the public at large through her book “Power to the Patient: The Medical Strategist” and her monthly newsletter.