Very Irregular cycles

[Sarahbehill1]

Hi,

     I have never been regular my whole life. I started my period when i was 12 years old and i have always been around a week or 2 late every month no matter what. But i became pregant at the age of 18 only sexual active with my fiance (now husband) i had preeclampsia and my son was born 2 months early do to loss of all my amniotic fluid. i went on birth control for about 2 to 3 months after and then (becasuse im awful at taking pills on time..lol) I had an IUD. I kept it in for about 7 or 8 months and it gave me aweful periods that lasted 2 weeks more more and were only about 2 weeks apart so i had it removed went back on birthcontrol pills for 1 month and now i have not been on any birthcontrol for over a year. My periods are between 40 and 50 days apart and i have not become pregant in this years time. Can something be wrong??

[Keith Downing, MD]

Hello,

First, any woman with an absent period should have a pregnancy test first and foremost.  Other causes of absent or infrequent menstruation are thyroid abnormalities or increased prolactin levels.  Also, excessive weight loss or physical stress can result in absent or infrequent menstruation.

The most common reason women have infrequent menstruation, or anovulation, is due to the Polycystic ovarian syndrome.  This syndrome is notable for infrequent menstruation (oligomenorrhea), hyperandrogenism (this may be evidenced by excess hair growth in a male distribution) and slightly enlarged ovaries with multiple small follicles.  2 of these 3 elements are all that is needed to make the diagnosis.  Commonly, women who meet this diagnosis are obese and have evidence of insulin resistance.  This is important because it puts a woman's endometrium (the inner lining of the uterus) at greater risk of being exposed to unopposed estrogen, which can result in the overgrowth and/or abnormal growth of endometrial tissue (i.e., endometrial hyperplasia or endometrial cancer).  

This can easily be managed by taking the birth control pill (which has estrogen and progesterone). The pill will protect your endometrium and regulate your menstrual cycle.  Alternatively, a progesterone only form of contraception will provide endometrial protection, although most will not regulate your bleeding.  Examples are Depo Provera (an every 3 month injection), the mini-pill (a progesterone only birth control pill), Implanon (a single rod implant placed under the arm with a 3 year life span), a Mirena IUD (a progesterone impregnated IUD which can stay in place for 5 years) or the intermittent use of Provera to cause a monthly or every 3-4 month withdrawal bleed.  

Your physician should be able to help determine the underlying cause of your infrequent menstruation and discuss the many possible ways to approach managing it.

Best regards,

Dr. Downing  

[Sarahbehill1]

My periods only last between 3 and 4 days even though they are almost 2 months between them so i am hesitant to believe it is because of hormones and that my lining is backing up...i have heared that if this is the case your periods are heavier and last a little longer. and when i finally get my period my cramps are so aweful i can hardly stand them. I want to get pregnant...how can i do so with this problem and what could be causing it?