Peri-menopause and Irregular Periods
Before menopause makes your periods stop completely, you may notice changes in how often you get them, and in the amount of flow you have. If you’re going through natural menopause and have entered peri-menopause, irregular periods can be part of the normal aging process. But you also might have irregular periods if you’re going through induced or medical menopause as a result of breast cancer treatment.
What is an irregular period?
Before peri-menopause, the level of estrogen in your body rises and falls at regular intervals, triggering your monthly period. But during peri-menopause, estrogen levels rise and fall unevenly. There is also less overall estrogen in your body, which means your ovaries may not release an egg every month. Inconsistent estrogen levels lead to irregular periods.
It’s important to remember that even if your periods are irregular, you can still become pregnant. If you don’t want to be pregnant, you must use reliable birth control.
Irregular periods can mean a number of things.
As you move through peri-menopause, you may find you have a period every other month or only once or twice a year. Even if you only have one period a year, you’re still considered to be in peri-menopause. It can help to keep a record of when your period starts and stops. Once you haven’t had a period for 12 months in a row, you’re considered to be through menopause and are post-menopausal.
Shifting estrogen levels may cause your periods to happen more or less often than you’re used to (a 28-day cycle is average, but this can vary from person to person). Your period also may last longer than it normally does.
The changing estrogen levels during peri-menopause can make the lining of your uterus thinner or thicker, which can make the blood flow during your period lighter or heavier.
Again, changes in estrogen levels can make your period so light that you just have spotting instead of regular blood flow.
Does breast cancer treatment cause irregular periods?
Just as breast cancer treatments can cause early menopause, they also can cause irregular periods.
Hormonal therapy medicines, such as tamoxifen or the aromatase inhibitors, lower estrogen levels in your body and can cause irregular periods.
Chemotherapy can cause the ovaries to stop working, which can lead to irregular periods.
If your ovaries are shut down with medicine, they will stop working temporarily and you may have irregular periods before your periods stop completely.
If your ovaries are removed with surgery, they will stop working permanently. You won’t have any more periods and will be considered post-menopausal.
When to talk to your doctor
Changes in your menstrual periods usually don’t require treatment. One exception is if you have heavy and irregular bleeding, called abnormal uterine bleeding by doctors. Depending on your symptoms and risk factors, your doctor may recommend certain tests to check the lining of your uterus.
It can be very confusing to figure out the difference between a normal change associated with peri-menopause and what may be a sign of something more serious going on inside your uterus. Tell your gynecologist about the type of symptoms you’re having, as well as how long they’re lasting, to be sure.
It’s a good idea to track any changes in your cycle and talk to your doctor about them, especially if you’re receiving breast cancer treatment.
You may want to keep a log in a notebook or in your phone that includes:
when each period starts
how long it lasts
how heavy it is
if you have any spotting in between periods or in place of a regular period
— Last updated on January 30, 2024 at 10:30 PM