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Irregular periods
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Meg11 posted:
Hello! I am 26 and have always had irregular periods ever since I began menstruating at the age of 13. By irregular, I mean that I have never known when they would start. Often, they'd be 3-4 months apart. Doctors could not find any cysts (they found one but it resolved by the second ultrasound) and my thyroid levels have been normal. By a miracle, my husband and I became pregnant January 2011 and I gave birth to a beautiful baby girl October 2011. After her birth, I went on the progesterone only pill. I had spotting right away but my periods officially returned in April 2012. They occurred roughly every month until September, when I started getting them every 2 weeks. I wasn't breast feeding anymore by then so I went on normal birth control pills. However, we moved to Italy in November so when my pills ran out in December I could not get more and have been off them ever since. I had a period, then another two weeks later, and then I didn't have one for another 40 days.

This brings me to my question (sorry for the long history). My current period is the one I just mentioned, and it has been very strange. 2 or 3 weeks ago I was sure I was pregnant. My breasts felt like they did when I was nursing (the tingling sensation in the glands), I was tired and moody, etc. However, a preg test came out negative. Then, three days ago I had red blood in my panties and naturally thought my period was starting. However, then for two days after I had only brown discharge when wiping. Then red blood came in the morning but stopped that evening. It was back to light res or brown when wiping. Then 12 hours later the red started again. It is dying down again, now 12 hours later.

My question is: does this period sound strange enough that I should be seen by a doctor? Also, could there be any other reason for my lifelong irregular periods other than thyroid issues?

Thanks for your help!
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Jane Harrison Hohner, RN, RNP responded:
Dear Meg: Wow, living in Italy. I envy you as I love Italy. But I'm sorry that you are having these GYN issues with a 16 month old, having recently moved.

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.

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/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.

As you may have read, causes for not ovulating are many: low thyroid (ruled out in your case), pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with partners/family, money), increased body weight, anorexia, rotating shifts at work, etc. In your specific case there are several possible culprits: recently stopping regular birth control pills, and moving to a different country. You also have a known history of irregular ovulations.

Yes, bilateral breast tenderness can be a very early sign of pregnancy, appearing as early as two weeks after conception. This is thought to be related to increasing levels of hormones such as estrogen. In a month without an ovulation, not only can a menstrual period be missed, but there can be breast tenderness as well. This is similar to the increased breast tenderness experienced by some women when first taking postmenopausal hormone therapy.

I would urge you to establish care with a GYN by getting another pregnancy test done just to definitely rule out an undetected pregnancy. That way, if you do develop prolonged or heavy bleeding you have a place to receive care. I would hope that your cycles reset themselves naturally. Your daughter's birth confirms that you do ovulate--even if it is not always super predictable.

Yours,
Jane
 
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Meg11 replied to Jane Harrison Hohner, RN, RNP's response:
Thank you, Jane! I appreciate you taking the time to reply. This is great information, and I will find a doctor here who can see me and hopefully help me find further answers. Thanks again!


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