Ever had a menstrual period just a couple of weeks after your previous one? Have you gone for several months without having a period, only to start having seemingly regular monthly periods again? Irregular periods are common during menopause and they can be inconvenient, uncomfortable, and even a little unnerving.

Menopause, similar to adolescence, does not have a definite start and end date. Rather, your body takes a few years to adjust to the hormonal changes. During the transitional times sometimes referred to as peri-menopause, your periods become almost as erratic as during your teen years. For some women, irregular periods are just the beginning; women may experience more severe menstrual cramps than before. Another common complaint is increased breast tenderness. But what about the monthly cycle itself – why does it become so unpredictable?

One of the results of those fluctuating hormones is that many women do not ovulate during a menstrual cycle. As ovary egg production slows down, an egg may not be released during ovulation. But the uterus is still anticipating the possibility of pregnancy and consequently builds up the blood supply in the lining of the uterus, or endometrium. The endometrium is shed when an egg was not fertilized during ovulation, which means a monthly flow.

During menopause the uterus will often build up quite a bit of blood supply and results in heavier periods for some women. At the same time, progesterone which is made in the ovary is decreasing. Progesterone is what normally prevents the endometrium from building up during ovulation. A proliferative pattern is where the body does not produce enough progesterone. The endometrium blood supply is much more than normal and heavier periods occur.

Stress levels during menopause also affect the body’s natural rhythm. When the ovulation process is disrupted you might have fewer periods than usual. Some women stop practising birth control at this time, thinking they are no longer at risk of becoming pregnant. But until a woman is entirely finished having periods, either after a twelve month period of by way of surgery, pregnancy is always a possibility.

Initially your periods may become less frequent and the flow may be lighter than in the past. But while the uterus still prepares for possible pregnancies, the endometrium will continue to shed during menstruation. Only now it might occur in a more unpredictable pattern or a sort of ‘bits-and-pieces’ pattern. You might also notice periods occurring more frequently. Be sure to make the distinction between another menstrual cycle and erratic spotting as the latter could be a sign of something more serious.

If you have had irregular periods for at least three months, you should see your healthcare professional for a hormone test. A hormone test will confirm whether your irregular periods are due to menopause or if there are other causes such as endometriosis. Keep track of when your periods occur, how long they last, the flow amount, whether you are using more or fewer pads or tampons, and any other details that you can show to your doctor.

Some women look forward to the end of monthly periods, some women are apprehensive about this time. But pretty much all women would rather not have to deal with irregular periods during menopause and peri-menopause. Become familiar with your body’s natural cycles and be on the lookout for any changes. Your doctor can help you find a possible solution to lessen the impact of those unpredictable periods.

Menopause, Your Doctor, and You