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Irregular Periods

Too Frequent or Not Frequent Enough

Many women have irregular periods, and they are not usually associated with ovulation. Without ovulation a woman will not get the typical breast tenderness or cramps so often associated with a period. Without regular ovulation it is difficult to get pregnant, compared to those women who ovulate each month. Irregular periods can be more often than monthly or less often than monthly. Irregular periods may be heavier, lighter than normal, and the amount of bleeding may vary for each period.

What You Should Know

It is Not Dangerous to have irregular periods if everything else is normal. There are tests to look for the “everything else.” Which tests are indicated depends upon each patient’s individual situation.

Testing

  • TSH Blood Level: This is a thyroid test which tests your TSH (thyroid-stimulating hormone) looking for overactive or underactive thyroid. Abnormal thyroid function can make periods go away. The “fix” for those periods is fixing the thyroid function.
  • Prolactin Blood Test: This measures a specific function of the pituitary. The pituitary is an endocrine (hormone-producing) gland in the brain. If certain cells in the pituitary grow too much they can make too much prolactin (luteotropic hormone or luteotropin), and make periods stop. The fix for those stopped periods is medicine to ungrow those cells.
  • FSH Blood Level: This is elevated in menopause. A low FSH (follicle-stimulating hormone) pretty much excludes menopause. FSH should be measured at the end of the placebo week (sugar pill week) of the birth control pill pack, to be accurate. Periods stop in menopause; the average age of menopause is 50-51 years old. Women in menopause do not need a contraceptive. [read more]
  • LH Blood Level: LH is the Luteinizing hormone. This is sometimes measured, and has to do with PCOS (poly cystic ovarian syndrome). PCOS can cause irregular periods. Read more…
  • Estrogen Blood Level: Very low levels of estradiol may help clarify hormonal status if the FSH is low and periods are Absent. This is rarely necessary.
  • Endometrial Biopsy: This is a special sampling of the cells at the lining of the uterus. It is done just like a pap smear, only it is more crampy. This test is intended to prove there is no cancer or pre cancer inside the uterus. This test can also prove if a woman has ovulated.
  • Ultrasound: An ultrasound of the uterine lining can exclude cancer in very specific circumstances, and is generally not done for women younger than 50. An endometrial biopsy can be more reliable than ultrasound.
  • Complete Blood Count: This test can determine whether your blood level is Low, known as anemia. Sometimes your body can make more blood fast enough to keep up with heavy periods. Other times your body might not be able to keep up production, in which case you will have a low blood count. A very low blood count can be dangerous.

Periods are Irregular & Everything Else is Normal

Women used to be told that they must have a period each month. It was supposed to be healthy. The real story is a little different. The cells inside the uterus must be exposed to progesterone to remain healthy and not dangerous. Women get progesterone in one or more of the following ways:

  • All forms of hormonal contraception
  • Progesterone pills, like medroxyprogesterone acetate and norethindrone.
  • Ovulation, either naturally, or with the help of clomiphene citrate or fertility drugs.

The right fix for you depends upon your specific needs at each phase in your life. All patients are evaluated to confirm nothing is wrong. Once we establish the irregular periods don’t represent danger, the choices include:

  • Regular periods and/or contraception
  • Pregnancy
  • Do nothing

Heavy Periods and Menstrual Regulation

Heavy periods and extra bleeding outside of your normal scheduled period can be handled in a number of ways depending on what tests show…[read more]


ADDITIONAL TOPICS

Menopause

Always feel like the hot one in the room? You’re not alone. Menopause doesn’t have to be a struggle….[read more]

Pain

Pain “down there” can be caused by a number of reasons. You deserve to be pain free. Here is helpful information about what might be causing pain…[read more]

Contraception

Your options for contraception are more than just a daily pill. Hormonal contraception includes a pill, shot, IUD and more…[read more]