Coming menopause period is a qualitatively new stage of every woman’s life. The slow decrease in ovaries function is experienced after 35 years of age, a number of anovulatory cycles is increased, but till about 45 years of age all these changes remain invisible for women. The further decrease in level of female sex hormones produced by the ovaries leads to abnormal menstrual cycle, changing in duration. Delays of menstruation are getting more often and at last, they stop, and this means menopause.
Besides an evident affecting menstrual function, sex hormones affect practically all other tissues. Deficiency of the sex hormones produced by the ovaries leads to appearance of typical symptoms. Nine of ten women during this period observe changes in health state. It is not only hot flushes known to most of people. Typical symptoms of the menopause period are psychological discomfort, irritability, sleep disorders, changed sexual inclination, autonomic neuropathy symptoms: night hyperhidrosis, palpitation, high arterial pressure; changes, typical for atrophic processes: skin flabbiness, dry vagina, urinary incontinence, and fat tissues redistribution. Many women feel confused by coming changes.
At the first sight, the following late symptoms of menopause, such as coronary disease, osteoporosis, and degenerative changes of the central nervous system, are not so evident effect of deficiency of hormones, and observed in 10-15 years. So, to find out the reason of variety and diversity of menopause symptoms, we have to learn about endocrine system and hormones and reproductive system function.
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What about conventional medicine?
If you are worried about your irregular periods or think they may be caused by an underlying health issue then it is important to visit your doctor, as treatment to solve the root of the problem may be found.
Heavy or prolonged periods should also be checked by your doctor. Please do not suffer heavy or prolonged bleeding because you are menopausal – always take steps to reduce this problem with your doctor’s help, as excessive blood loss is detrimental to health.
If your irregular periods are caused purely by hormonal changes, your doctor may prescribe HRT or birth control pills. It is important to discuss the side-effects of these drugs to establish if these are the best solution for you
Irregular periods is a common symptom of the menopause
Irregular periods are a common symptom of the menopause. As you enter the menopause your hormone levels begin to fluctuate and decline, often having a knock-on effect on your menstrual cycle. Here, our menopause expert Eileen Durward discusses herbal and home remedies that can ease this symptom until your periods stop.
An introduction to irregular periods
Very few women reach the menopause without first encountering irregular periods. For many, it is the first indication of the peri-menopause, a time of life coming between two to ten years before the menopause.
Every woman has a different menstrual cycle, meaning that periods will come at different times. Periods coming too frequently or too infrequently are the obvious indications of irregular periods, although shortened or lengthened period duration is also common.
It is important to remember that while fertility does go into decline as you go into the menopause, it is still possible to get pregnant, even when your periods are irregular. Some women go for months, as many as 12-15, without a period before they start again. While this can be worrying, it is a common occurrence during this time of life and should not be a cause for alarm.
In addition, women may find that they experience spotting between irregular periods. Again this is a normal part of the menopause and is caused by fluctuations in hormones. However, if you are worried about your symptoms, it is worth seeking medical advice for added reassurance.
Why does menopause cause irregular periods?
Your periods are regulated by the hormones oestrogen and progesterone. These hormones drive the menstruation process and as you reach menopause, levels begin to decline. Often this is not a steady or gradual descent, but an erratic oscillation. This means that your periods will also begin to fluctuate, sometimes coming more frequently than usual, sometimes less so.
Other factors can also trigger irregular periods. These range from increased stress or changes in diet to underlying health issues such as diabetes. If you suspect that your irregular periods are caused by an underlying health condition, it is important to seek medical advice to help with this.
What home remedies are there for irregular periods?
It is important to remember that irregular periods are a normal part of going through the menopause in the lead up to your periods eventually stopping. However, there are some home remedies which could offer you some relief from the symptom.
Your diet is important for maintaining your general health and wellbeing. It has been shown that a diet lacking in fruit and vegetables but filled with refined sugar and caffeine does not provide essential nutrients and vitamins for the body. This can exacerbate your problem.
Extra stress may play a role in making your periods irregular. It is important to minimise stress as much as possible by taking time to relax. Making sure that you get enough restful sleep will help reduce stress and the impact it has on your cycle.
Smoking can also negatively impact your health. You may find that cutting down the number of cigarettes you smoke each day or stopping altogether eases your symptom as well as allowing your general health to improve.
Are there herbal remedies to help me?
This stage of the menopause is often short-lived and often, no treatment is needed as the normal course of events will lead to periods stopping altogether. However, there are some situations when herbs can help.
If you are approaching the menopause and your irregular periods are accompanied by other symptoms which remind you of PMS such as bloating or breast tenderness, try a short course of Agnus castus for two or three months. This will help balance your hormones as you go through this stage of life.
Changes in periods resulting from declining levels of oestrogen and progesterone, the two hormones produced by the ovaries which control the menstrual cycle, are usually the first sign that the menopause is near. We asked women to tell us how their periods changed during the menopause, the effect this had on their everyday lives, and how they coped with heavy bleeding.
Most women expected irregular periods and other menopausal symptoms at some stage in midlife, even if they were unwelcome (see ‘What is the menopause?
’). For others, however, particularly those who felt too young for the menopause or who knew little about it, missing a period could be a worry. Some women thought they might be pregnant. (See ‘Early (premature) menopause
’ and ‘Relationships, sex and contraception
Women were surprised about all sorts of other differences in their periods and cycles (see ‘What is the menopause?’). One woman described her periods as coming ‘whenever they wanted to’, sometimes two close together, then gradually further and further apart, longer and heavier, then shorter and lighter for three years until they finally ceased. Another woman found her irregular cycle ‘confusing’. After having periods two weeks apart, she then had ‘heavier than normal’ periods every couple of months before they returned to a normal monthly pattern.
Periods might last two days or six or even longer; they might be very heavy or quite light. Several women experienced stomach pain. Some women said their menstrual blood looked different in colour and consistency. One described it as ‘almost globular’.
Effect on everyday life
The erratic nature and unpredictability of periods can be annoying, and at times embarrassing and debilitating. Women talked about the uncertainty they faced not knowing when to expect a period, or whether it would be heavy or light. They spoke about the inconvenience of periods which were ‘stop start, stop start’; and about the difficulty of making plans when periods ‘started coming twelve, thirty six and then seven days apart’. They needed to be organised and prepared with tampons and sanitary pads at all times, and feared being caught out in public places.
Treating heavy bleeding
Heavy bleeding, or menorrhagia, can dent the quality of life. Women talked about various treatments they had tried to control heavy bleeding. One woman took hormone replacement therapy (HRT) (see ‘Hormone replacement therapy (HRT)’) to regularise her heavy and erratic periods which were ‘getting in the way’ of her new relationship. Another was prescribed norethisterone, a synthetic progestin used to control heavy bleeding, but stopped taking it when she put on weight.
Several women had the Mirena coil fitted to regulate bleeding. This is a plastic device inserted into the womb, which releases a synthetic progestin called levonorgestrel. It can also be used for contraception (see ‘Relationships, sex and contraception’). Some women’s periods became lighter or stopped altogether while using the Mirena coil.
Although heavy bleeding can be a part of the normal menopause, some women worried and consulted a doctor. In some cases they were diagnosed with anaemia (iron deficiency caused by heavy bleeding). Once they began taking iron tablets their energy levels returned. In some women, heavy bleeding was a sign of underlying problems such as polyps and fibroids and needed referral to a specialist. It’s important to investigate any bleeding 12 months or more after the last period.
Tests to confirm the menopause
Changes in periods, a woman’s age, and symptoms such as hot flushes usually indicate that the menopause has started. However, when periods become irregular some women ask their GP for a blood test to confirm that the menopause has begun. Tests are available to measure levels of the follicle stimulating hormone (FSH), which rise as oestrogen levels fall. However, although useful in diagnosing early menopause (before the age of 40) (see ‘Early (premature) menopause’), the tests can be unreliable for women in their forties as hormone levels fluctuate. For this reason doctors may hesitate to order tests routinely.
Although fertility declines during the menopause, pregnancy can still occur. Women are advised to continue to use contraception for one year after their periods stop if over 50; or for two years after periods stop if under 50 (see ‘Loss of fertility’ and ‘Relationships, sex and contraception’). For many women, the end of the menopause brings with it a sense of freedom from the unpredictability and inconvenience of periods and the fear of getting pregnant.
The most difficult situation to handle is probably very heavy, extended bleeding, or flooding cycles. If this happens many of us will become anaemic (lack of iron in the blood) as the body doesn’t have time to make up for blood loss before the next period. We can end up feeling weak, exhausted, and maybe even depressed as a result of the anaemia, which then becomes associated with the menopause.
Very heavy bleeding can also be caused by fibroids. If you experience prolonged heavy bleeding, seek professional advice from your GP, homeopath or other health expert. Vaginal bleeding is not normal after the menopause so again get professional advice if this occurs.
Some women develop symptoms of Premenstrual Syndrome (PMS) for the first time or have more acute levels of their normal PMS. These symptoms can be physical, psychological, or emotional. Most of us will have had some level of PMS during the second half of the monthly cycle over the years. Symptoms may have been getting stronger during our 30s and 40s, approaching menopause. Most common symptoms are irritability, aggression, tearfulness, mood swings, breast pain and fluid retention.