Am I experiencing early menopause?
Dear Dr Mitchell,
I am 37 years old. My periods were always regular — 28 days like clockwork — but recently, in the last year or so, they have been varying between 24 and 30 days. Is this normal, or should I be concerned? I’m not on birth control, and I still experience cramps, though I now bleed for just two days, instead of the usual five. Is this a sign of early menopause? I was on the pill for about two years, but stopped completely two years ago.
The normal menstrual cycle varies between 21 to 35 days counting from the first day of the menstrual bleeding. On average the normal menstrual cycle is usually reported as being 28 days. Any variation between 21 to 35 days is, however, considered normal. Women who ovulate tend to have regular, predictable cycles with some amount of breast tenderness, mid-cycle (day 14 to 15) cramping, bloating and change in the consistency of the cervical mucus. On the other hand, women who do not ovulate tend to have irregular, unpredictable cycles which are usually painless.
There are several factors that can cause a change in the menstrual cycle. Stress is a big contributor and in some cases can prevent ovulation and cause the menstrual period to be completely absent. Stress can be due to domestic stress, frustration, change of schools, or change in occupation. Excessive exercise and drastic dieting with excessive weight loss can also cause a change in the menstrual cycle. On the other hand, excessive weight gain can also cause a change in the menstrual cycle since this can prevent ovulation from occurring.
Certain medications, especially antidepressants and antipsychotic drugs, can interfere with ovulation and cause alteration in the menstrual cycle. Premature onset of the menopause can also cause alterations in the menstrual cycle. This may be preceded by hot flashes, irritability, depression, and then the irregular menstrual cycle.
The fact that the menstrual flow is now lasting only two days is significant, but does not necessarily signal the onset of premature menopause. You should get a hormonal profile done. This should include a thyroid function test, (thyroid-stimulating hormone – TSH), prolactin, leutinising hormone (LH), follicle-stimulating hormone (FSH), and testosterone level. If you are premenopausal, then the level of leutinising and follicle-stimulating hormones will be higher and in the menopausal range.
If the levels are normal and the rest of the hormonal profile is normal, then you have nothing to worry about. If you are not ovulating, then when you desire conception, drugs can be used to stimulate ovulation and improve your chance of becoming pregnant.
Consult your doctor who will advise you further.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER
The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
