An interview with
Wendy Draper, MD Obstetrics and Gynecology
The Vancouver Clinic
Get help for menstrual problems
It’s not unusual for a woman to have trouble with her menstrual cycle – a missed period, spotting at usual times. Frequently, a woman’s cycle will return to normal on its own. But ongoing irregularities, lasting three to four months, should prompt a visit to the doctor.
Meantime, you may wonder what’s normal. Here are some common menstrual problems and possible causes.
Abnormal bleeding: Break-through bleeding is not uncommon for women on birth control pills. This may occur if a pill was take late or missed altogether. Other factors of abnormal bleeding include hormone problems, thyroid irregularities, polyps and fibroid growths. Cancer of the reproductive organs is as a possibility, although a less common concern.
Missing a period: The most common reason for missing a period in younger women is pregnancy. For older women, it may be a sign of perimenopause – the years leading up to menopause when cycles tend to be erratic. Hormonal changes at any age could mean you skip your menstrual cycle.
Short or long cycles: Normal menstrual cycles are usually between 22 and 35 days. But what is “normal” for you may be very different from the cycle of another woman.
If your cycle is very short – such as a period every two weeks – you should tell your doctor. Or, if your cycle is usually consistent and suddenly changes, see your doctor as well.
Light bleeding: Although many women might not see this as a problem, it could be a sign of a hormonal imbalance and should be brought to your doctor’s attention.
Bad cramping: More than half of all women have some menstrual pain for one or two days each month. Endometriosis is a common source of such pain. In this condition, tissue similar to that of the lining of the uterus is found in other areas of the body, such as in the ovaries. This tissue reacts to the hormonal changes of a woman’s menstrual cycle just as the lining of the uterus does – by swelling, bleeding and causing pain.
Other causes of cramping include fibroid growths in or on the uterus, and pelvic inflammatory disease.
If your pain is severe or lasts more than a few days, talk to your doctor – there are effective ways to treat menstrual pain.
IS IT MENOPAUSE?
You’re a 40-something woman, and you haven’t had your period for several months. Have you passed through menopause?
Maybe –or maybe not.
Many middle-aged women skip a few menstrual periods and assume they have reached menopause, only to have their periods resume after a few months. They may be in a transition period leading up to menopause called perimenopause.
As a woman ages, her body makes less of the hormones estrogen and progesterone. The possible results: side effects such as hot flashes, mood swings, and erratic periods. Such symptoms may begin as long as five years before the onset of menopause.
Eventually, hormone production falls so low that a woman no longer has any periods. When a woman has not had her period for 12 months, she is officially, postmenopausal (assuming no other problem is causing the lack of menstruation). This usually happens between the ages of 45 and 55.
Source: National Women’s Health Information Center
Published January 2008.