Irregular periods

You guessed it – hormones! Specifically, two of the major hormones that shape our natural fertility cycles – oestrogen and progesterone. As a result, they are also control our periods (along with a range of other functions in our bodies).

Before a woman enters the menopause transition, oestrogen and progesterone work in sync with the brain and ovaries to cause the changes that happen in a normal monthly cycle. These hormones cause the lining of the uterus to thicken in preparation for receiving a fertilised egg. When this doesn’t happen (i.e. you aren’t pregnant), the uterus sheds the unused lining – and the process starts all over again in the next cycle.

During perimenopause and leading up to menopause, oestrogen and progesterone levels start to fluctuate and sometimes end up out of sync with each other, communication between the brain and ovaries stops working like it should, and the uterine lining doesn’t thicken like it used to. This is what leads to changes in your monthly period. How your cycle changes is unique to your body, but research tells us that during early perimenopause, it is likely to be more frequent, heavier and occasionally not at all. As you move closer to menopause, the gaps between your periods will grow, they may become lighter, and will eventually stop completely. Once you have gone 12 months without a period, you have reached menopause.

For most women, they won’t have any further bleeding after they have reached menopause. There are some factors that could cause postmenopausal bleeding such as fibroids, polyps or certain cancers. It could also be completely benign and as a result of the thinning of the tissues in the vagina, cervix or womb which may lead to bleeding.

If you experience bleeding after you have been confirmed to be postmenopausal, please see your healthcare provider as soon as possible.

There are other factors that can also impact your period. Stress, illness, thyroid conditions, adrenal problems – or even pregnancy. Until you are confirmed by a doctor as post-menopausal, continue to use contraception to avoid unwanted pregnancies.

Here are a couple of things that you can do to help manage irregular periods during menopause.

• Consider supplements: There is limited research that provided evidence for the usefulness of supplements to help with heavy bleeding, although they may be helpful in maintaining good overall health which may aid in you feeling better throughout the menopause transition. There are two natural supplements that have shown some promise:
  • Ginger Monk’s pepper: the anti-inflammatory properties of ginger may help in reducing heavy bleeding and cramps. Try a fresh ginger tea and see if this helps you.
    Monk’s pepper (aka vitex, chastetree or Abraham’s balm) – this herbal remedy increases progesterone, which can help to regulate menstrual cycles. It may be useful during early perimenopause when you may notice your cycles getting closer together.
• Non-steroidal anti-inflammatory drugs (NSAIDs): these are common medications (e.g. ibuprofen, mefenamic acid) that can be used to help reduce heavy bleeding. Your healthcare provider can assess whether this might be suited to your needs and give you a prescription for them.
• Consider using hormonal contraceptives: as mentioned earlier, women who use certain contraceptives such as Depo-Provera injection or the MirenaTM coil, may not experience any periods and/or very light ones. This may be a solution for women who are struggling with very heavy, frequent periods. Speak to your healthcare provider to see what is right for you.
• Medical procedures: there are a range of medical procedures that may help reduce severe bleeding and other menstrual-related issues experienced during the menopause transition. You should discuss your options with your doctor, to see what may be right for you.