Irregular Periods and Menopause

Has your Aunt Flo been super reliable your whole life? As in, can you count on her to come on or around the same time with the same amount of baggage (i.e. cramps, bloating … typical PMS symptoms) and leave around the same time every month? I hate to break it to you, but those days of “regular” periods are going to come to an end thanks to Aunt Flo’s successor—menopause—who is now trying to be your new sidekick. Or, maybe you’ve been dealing with irregular periods your whole life. As the British would say, those can be bloody awful (get it?!). Regardless of your period past, the Big M is going to steal Aunt Flo’s spare bed and move in permanently. During the move, she’s going to kick your periods to the curb and not-so-subtly replace them with irregular periods. But, guess what? When she’s fully moved in and adjusted, you’ll eventually enjoy life without those monthly visits, including all the baggage. I mean, moves can be tough, but I’m all for this one, aren’t you?

Note! For a deeper dive into all things period-related, be sure to get in the flow, and get in the know about menstrual cycles and menopause. For now, I’m just sharing the basics to keep us on the same page as we head in another direction—irregular periods.

irregular periods

What Are the Basics About Menopause and Menstrual Cycles?

What Is Menopause?

Menopause is a natural process that occurs when ovaries age and produce less reproductive hormones. If you aren’t aware menopausal changes are coming, they may feel downright overwhelming, isolating, and scary. Couple that with information being conflicting or hard to find, not knowing which health care professionals to visit, and which treatments to take, and BAM! That’s the signpost up ahead: your next stop, The menopausal Land of Confusion! The good news is that menopause is 100% manageable, and unlike the Twilight Zone, you will eventually leave it. You don’t have to let your limitations limit you. 

So, why does menopause meet us in midlife and take us on such an adventure? Because our bodies begin to undergo several changes in response to lower levels of estrogen, progesterone, testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). The ups and downs of these hormone levels during perimenopause cause an onslaught of symptoms, including but not limited to irregular periods.

What Are Menstrual Cycles?

What does having your menses mean? In short, menstruation is the time when a woman’s womb sheds its lining and blood and tissue flow from the uterus through the cervix and out the vagina. For regular periods, which include four different phases, women menstruate around every 28 days though some experience shorter or longer cycles (from 21 to 35 days). Every person is different—including their periods. Some happen like clockwork. Others are like clock-not-work; unpredictable but regular periods usually last about 2 to 8 days. 

What Are Irregular Periods?

So, now that you know what menopause and regular menstruation are (and yes, some people do have regular periods up until The Big Change comes a’knockin), what’s the deal with irregular periods? Why do we get them during perimenopause?

Why Do Irregular Periods Happen Leading up to Menopause?

Why do we get irregular periods during menopause? Well, one of the most notable changes during the perimenopause-to-menopause journey is the loss of active ovarian follicles. For those of us who aren’t medical experts (ugh, most of us, or you probably wouldn’t be here), the ovarian follicles are structures that produce and release eggs from the ovary wall, allowing menstruation and fertility.

The release of the egg on a monthly basis means that Aunt Flo will be arriving  at any minute. So, when you lose these active ovarian follicles, your period stops. See ya later, Aunt Flo! #ThanksButNoThanks for all of the monthly visits.

When Do Irregular Periods Related to Menopause Start to Happen?

When will we experience irregular menstrual cycles? You will start to have irregular periods during the first stage of the menopausal transition: perimenopause. The average age of onset is 51, but you may notice perimenopausal symptoms as early as your 40s. To complicate things further (and er, make things really exciting), some people notice changes as early as their mid-30s.

During this stage, estrogen levels in your body rise and fall, which has a big impact on your menstrual cycles. As ovulation becomes more unpredictable, the length of time between periods may be longer or shorter, your flow might be heavier or lighter, and you might even skip periods. It’s a triple-threat of unpredictability! If you have a space of 60 days or more between periods, then you’re most likely going through perimenopause. 

How to Cope With an Early Menopause?

Wondering what will happen if you enter the stages of menopause earlier than expected? You know how I just mentioned that menopause could happen as early as your mid-30s? Well, according to researchers at Sarah Cannon, the Cancer Institute of HCA Healthcare, early menopause (AKA premature menopause) “may be a result of several different therapies. These include the surgical removal of the ovaries, damage to the genetic material of the ovaries through radiation (caused by ovarian absorption of high doses of radiation administered to the abdomen or pelvis), or chemotherapy through exposure to an ovotoxic agent.”

The researchers continue on to say, “Having the ovaries removed will cause permanent menopause. Also, women over the age of 40 receiving chemotherapy or high dose abdominal/pelvic radiation have a greater chance of experiencing forced permanent menopause. Temporary menopause can be caused by certain chemotherapies or drugs (such as anti-hormonals) that will interrupt ovarian function, but can return once treatment is completed. This chance is greater for women under the age of 40.”

If you’re going through an early menopause, then I’m sending tons of virtual hugs and fresh-baked cookies your way, each topped with icing that reads, “Kick Menopause’s Butt!” Also, I want to share all sorts of tips to help you overcome and cope with early menopause. So, check out these posts. I’d love to “hear” your best practices too. Comments are open!

What Are the Differences Between Regular Periods and Irregular Periods?

So, how do you tell if you’re experiencing regular or irregular menses? When you start to make the menopausal transition, you’ll begin to notice that the time between each period will start to change. You might also notice more or less blood during a period than usual. Some days your period pads may look like the minimalist art of Yayoi Kusama, and other days, they may resemble the works of Jackson Pollack. The number of days that your periods last might vary a lot, too. This will all happen during the first stage of the menopause transition: perimenopause.

What Are the Causes of Irregular Periods?

To be the most informed possible, what things impact my periods and whether they are regular or irregular? According to the brainiacs over at WebMD, “Many things can cause irregular periods. Changes in your body’s level of the hormones estrogen and progesterone can disrupt the normal pattern of your period. That’s why young girls going through puberty and women approaching menopause commonly have irregular periods.” See? This is one way menopause can make you feel like a kid again!

Other common causes of irregular periods include:

So, there’s no need to freak out if you’re approaching the menopausal transition and you start to experience irregular periods. You know the saying, “It’ll get worse before it gets better?” In the case of menopause of periods, they’ll get BIGGER before they get GONE. It’s all part of the beautiful process that leads to a life of NO PERIODS. Yay!

Perimenopause and Irregular Periods

How Long Does the Irregular Period Phase of Perimenopause Last? 

Will irregular menstrual cycles last forever once you enter the stages of menopause? Great question! According to the pros at Healthline, “Perimenopause symptoms occur for 4 years, on average. However, perimenopause can last anywhere from a few months to 10 years. During this time, the hormones estrogen and progesterone are in flux. Your levels will fluctuate from month to month. These shifts can be erratic, affecting ovulation and the rest of your cycle. You may notice anything from irregular or missed periods to different bleeding patterns.”

Can Irregular Periods and Issues Related to Irregular Periods Be Treated During Perimenopause?

If irregular periods are in your future, how can you still enjoy life? Typically speaking, you don’t need to treat irregular periods, especially as you go through the menopausal transition. It’s all part of the process, leading you to being period-free. However, there are times when irregular periods can get a bit cray cray. If your irregular periods are bugging you like a fly at a picnic, or a million flies at a picnic, or a suddenly suspicious lack of flies at a picnic, here are some treatment options for the various symptoms.

Spotting Between Periods

Description:

If you have a little bit of blood on your underwear between periods and you don’t need to use a pad or tampon, then you have what is called spotting. Spotting is the result of your body’s changing hormones and buildup of the uterine lining.

Treatments:

Keep a journal to track your menstrual cycles, as well as your spotting occurrences. If spotting is happening every two weeks, then be sure to talk to your healthcare provider. Also, purchase disposable or reusable panty liners to help protect you from leaks and stains.

Abnormal Bleeding

Description:

According to the fine folks at Healthline, “When your estrogen levels are high in comparison to your progesterone levels, your uterine lining builds. This results in heavier bleeding during your period as your lining sheds. A skipped period can also cause the lining to build up, leading to heavy bleeding. Bleeding is considered heavy if it soaks through one tampon or pad an hour for several hours, requires double protection — such as a tampon and pad — to control menstrual flow, causes you to interrupt your sleep to change your pad or tampon, and/or lasts longer than 7 days.”

Treatments:

You might already be taking ibuprofen (Advil, Midol, Motrin) during your period to help with menstrual cramps. But, did you know that it can also help with heavy bleeding? Healthline advises, “Try taking 200 milligrams (mg) every 4 to 6 hours during the day. If cramps and pain continue, talk to your healthcare provider about hormonal approaches to treatment. Some women have a medical or family history that discourages the use of hormones in the perimenopausal period.”

The researchers at the National Institute of Health (NIH) shared, “Painkillers like ibuprofen and diclofenac – both of which are non-steroidal anti-inflammatory drugs (NSAIDs) – are often used for the relief of menstrual pain and cramps, and also for heavy periods. In addition to relieving the pain, they may also help to lower the amount of blood lost. Acetylsalicylic acid (ASA, the drug in medicines like Aspirin) is not suitable for heavy periods because it has an anti-clotting effect so it can increase the amount of blood lost during menstruation.” Here are other items that the NIH suggested:

  • Hormonal Treatments:
    • Progesterone tablets
  • Birth control pills
  • Hormonal intrauterine devices (IUDs)
  • Surgical Treatments:
    • Removal of fibroids or polyps
    • Removal of the lining of the womb
    • Removal of the womb (hysterectomy)

As is the case with anything, be sure to run all of this by your healthcare provider.

Brown or Dark Blood

Description:

The colors you see during your menstrual cycles can range from bright red to dark brown. Brown or dark red blood is a sign of old blood exiting your body. 

Treatments:

The variation in color is usually due to the amount of time it takes for the blood and tissue to cycle out of the body. However, it can sometimes be a sign of another underlying condition. Be sure to contact your healthcare provider if you have concerns.

Shorter/Lighter Menstrual Cycles

Description:

When your estrogen levels are low, your uterine lining is thinner which results in shorter menstrual cycles.

Treatments:

You might find that tampons and menstrual cups are painful due to the thinner lining.Consider wearing panty liners or special underwear that is made for periods.

Longer/Heavier Menstrual Cycles

Description:

During perimenopause, your menstrual cycles might become longer and farther apart. Menstrual cycles are considered farther apart when they pass the 38-day mark.

Treatments:

According to the OB-GYN at the University of Colorado, “Many women experience heavy periods, and hormone-based birth control pills, patches, implants, injections, and vaginal rings are frequently prescribed to help treat this condition. Such birth control methods can reduce the menstrual flow by as much as 60 percent and lessen the duration of the flow.” Friendly tip: Use tampons, menstrual cups, and/or leak-proof underwear to help with the heavier periods, too. Oh, and stay away from white pants (*speaking from experience*).

Missed Cycles

Description:

As your hormones fluctuate, you might miss a period. Friendly reminder: You will hit menopause once you go 12 consecutive months without a period. If your cycles are still happening, but you’re missing a few here and there, then you can still get preggers. So, prepare accordingly!

Treatments:

Take a pregnancy test if you think you might be pregnant. You can also take a test to see if you are experiencing symptoms of perimenopause, menopause, or pregnancy.

When Should I Call My Doctor? 

Irregular periods are the most common during perimenopause. However, other conditions can cause abnormalities in menstrual cycles. Be sure to contact a professional if:

  • Your periods are changing and become heavy (even maybe have blood clots).
  • Your periods last several days longer than usual.
  • You spot or bleed after your period has ended.
  • You have spotting after sex.
  • Your periods arrive closer together.

Slice of Advice Rhyme Time: When in doubt, get checked out.

It’s a Wrap!

Irregular periods and menopause go together like peas and carrots (or ice cream and chocolate fudge … mmm … fudge). When you’re approaching the menopausal transition, you’ll go through stage one of the three-part journey: perimenopause. Your body will go through some pretty drastic hormonal changes which is totally normal. I repeat: Totally. Normal One of the first indicators of the transition is when you start having irregular periods.

You might have heavy bleeding, shorter cycles, longer cycles, darker blood, lighter blood, or no cycles at all. Aunt Flo is going to throw you for a loop for a little bit. It’s all part of the fun as your body prepares to say goodbye forever to this pesky, moody aunt forever. Just make sure you are prepared with the essentials: tampons, pads, period underwear, dark pants, menstrual cups … whatever is going to make you feel ready to take on the Irregular Periods rollercoaster ride and come out the other side ready to grab some cotton candy and head for the no-more-periods-ever carousel.

Sources

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