Women's Health Community

Dear An: You absolutely did the right thing in ruling out a pregnancy first in both of these abnormal "periods". It can be very difficult to diagnose something in retrospect so the following is my best GUESS.

In both instances, the two week late and the current too-light flow MIGHT have the same root cause. The most common reason for a menstrual pattern like you have described is not having a regular 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 normally 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—as a missed or late 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.

There can be MANY causes for not ovulating:low thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with partners, finances, kids), increased body weight, anorexia, rotating shifts at work, etc. You mentioned very severe cramping prior to that heavy flow. That might have indicated an ovarian cyst or a super heavy flow which produces increased numbers of prostaglandins.

Common menstrual cramps are caused by the release of prostaglandins from the lining of the uterus. Prostaglandins create both the cramps of labor and menstrual cramps by making the uterus contract. There are also receptor sites for prostaglandins in the bowel and central nervous system. Thus prostaglandins can produce not just cramps but also nausea/vomiting, diarrhea, headaches, and other "flu-like" symptoms.

An_250325, if your cycles have not reset themselves you should really see a GYN or even your local county family planning clinic. They should be able to assess for an ovarian cyst or other possible causes of the menstrual changes.

Yours,
Jane

Thank you so much for your advice. Ovarian cysts do run in my family which to be honest, was my main concern due to the fact that when my older sister was only a year older than I am now, She was diagnosed with an ovarian cyst. Also, Hyperthyroidism (I think thats the name of it) runs in my family as well. I am 8 days into it now and still nothing but some off and on bleeding for only a couple moments and then nothing for the rest of the day. I also took 6 more pregnancy tests. all with a very clear negative. I am planning a trip to my GYN ASAP but I do have one question, can Ovarian Cysts sometimes be cancerous? My older sister said something about it (that goodness hers were not) but a fairly distant family member died of Ovarian Cancer so its a very scary topic for me... Thank you so much again!

Dear Amberlynn: Hyperthyroidism can also be linked to "too light" flows, but by a very different mechanism from hypothyroidism. Thus, if there are other symptoms of hyperthyroidism you would likely be tested for this.

Ovarian cysts are NOT directly tied to ovarian cancer--especially the majority of ovarian cysts. Even when one begins to look at the less common type of cysts there is still low potential for malignancy. For example, dermoid cysts ("cystic teratomas") can contain bits of hair, teeth, or other body tissues. It is still not known why dermoid cysts form. At an incidence of 66%, dermoids are most common kind of benign tumors of the ovary. The concept of benign tumors sounds like a contradiction in terms. It means that there is a very small chance of this type of ovarian cyst to become cancerous. For example, in one study (Scully, 1973) less than 2% of dermoid cysts showed evidence of malignancy.

If you do have an ovarian cyst (usually found on ultrasound), the GYN should be able to tell you exactly what type it is. Most likely would be simple follicular cysts.

Yours,
Jane

ok thank you. That takes a major bit stress off. Thanks again