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Irregular Periods
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alamas08 posted:
After i had my son, he is now 4 years old. My menstrual has been irregular . Its been 3 months that i havent gotten my period, i went to go take a test to see if i was pregnant. but after the results came back they said i wasnt. I wanna know why does this happen, and what can it be.
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Jane Harrison Hohner, RN, RNP responded:
Dear alamas: Once pregnancy has been ruled out, the most common reason for a menstrual pattern like you have described is not having an ovulation every month. In a normal cycle, estrogen is produced all month. Estrogen is responsible for building up the lining of your uterus so you have something to shed each month. The good news is that you have enough estrogen to make a lining that does shed most times.

In a normal cycle, progesterone production increases following ovulation and release of an egg.. Progesterone "stabilizes" the uterine lining in preparation for a possible implantation of a new pregnancy. If you are not pregnant that month the levels of estrogen and progesterone fall, triggering the release of the uterine lining—your period.

So, if you do not ovulate, the estrogen build up of the lining continues, but without the usual ovulation associated progesterone. Thus, the hormone levels don't decline, and the lining stays up inside the uterus—your missed period. Alternatively, the built up lining can begin to shed on its own creating erratic bleeding patterns which are usually "too-light" or super heavy and prolonged.

If you have been several months without a period, a gynecologist may give you some progesterone in a pill form (eg Provera 10 mg for 5 days). Within 48-72 hours after stopping the progesterone your "progesterone blood level" will fall, triggering the release of the lining that has been building up. Many women report that these periods are very heavy-- as though several months of lining are shed.

Causes for not ovulating are multifold: low thyroid, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with spouse, money worries), increased body weight, anorexia, rotating shifts at work, etc. You mentioned that this erratic pattern began four years ago after the birth of your son. If you had your son late in life (eg after age 35) some of this could be a result of aging of the ovaries. If you gained additional weight with his pregnancy that you did not lose, the extra body fat can interfere with ovulations.

Honestly, you deserve the more "for sure" answer. Please go back to your GYN or clinic and ask them specifically about the three months of missed flows. They may decide to offer you some progesterone to kick start a flow, or do do a blood test for low thyroid.

Yours,
Jane


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