Expert answers to common questions about irregular cycles, heavy bleeding, PMS, and more.
Folio-id.comYou thought you had your flow all figured out, but there it goes, doing something wacky. "Around age 35, patients start saying, 'My periods aren't the same as they used to be,'" says Margaret McKenzie, MD, an ob-gyn at the Women's Health Institute at Cleveland Clinic. While exchanging stories with friends can be comforting (and fascinating), and even though most symptoms are innocuous, there are issues that require a doctor's intervention. Experts share the reasonsand what-to-dosfor the most common period puzzlers.
Why is my cycle irregular?
Blame too few eggs in one basket. "As egg numbers drop in women's mid- to late 30s, the hormone that stimulates the ovaries to develop an egg rises significantly," notes Mousa Shamonki, MD, assistant clinical professor of obstetrics and gynecology at UCLA. The egg develops more quickly, causing earlier ovulation and, in turn, menstruation.In your 40s, periods may occur later because it's harder for an egg to grow, which delays ovulation. To make sure thyroid disease, ovarian cysts or weight changes aren't causing erratic cycles, talk to your doctor if your periods arrive more often than every 21 days or less than every 35 days.
Why is my flow so heavy?
Nearly 20 percent of gyno visits in the United States are related to heavy menstrual bleeding, per a recent study in The New England Journal of Medicine. "As hormonal changes prevent regular ovulation, that egg-in-waiting continues to release estrogen. It builds up the lining of your uterus, which can result in a heavier flow," says Mary L. Rosser, MD, PhD, assistant professor of obstetrics and gynecology at Montefiore Medical Center in New York City. See your gynecologist, she says, if you're soaking through a pad or tampon every hour, bleeding longer than seven days, or have noticeably heavier or more painful periods for three or more cycles.
A doctor can rule out triggers that include fibroids (noncancerous growths), endometriosis (when the tissue that lines the uterus grows outside it), cysts and clotting disorders. If there's no known cause, she might prescribe low-dose birth control pills or the hormone-releasing IUD Mirena. Even if your flow is normal, change your tampon every four to eight hours, adds ob-gyn Hilda Hutcherson, MD, of Columbia University College of Physicians and Surgeons in New York City: "The warm, moist environment is the perfect breeding ground for a bacterial or yeast infection."
Why did my period disappear for six months?
Assuming you're not breast-feeding or in late stages of perimenopause (key sign: hot flashes), lifestyle factors may be the problem. "Being obese or underweight, overexercising and immense stress can short-circuit the area of the brain that triggers the flow of hormones that lead to ovulation," says Dr. McKenzie. So can thyroid disease, so speak with your doctor, even if you missed only two months. You'll likely get back on track with stress-relief techniques, simple diet and exercise tweaks, or medication.
Why is my PMS so intense?
Take comfort in numbers (and, OK, some chocolate): Premenstrual syndrome and all its ickinessbloating, irritability, anxiety, headaches and fatigueaffects three out of four women in their childbearing years, per the National Institutes of Health. With age, women may get more sensitive to the fluctuations in estrogen and progesterone linked to PMS. What can help: adequate sleep, regular exercise, relaxation techniques (like yoga), and holding back on alcohol, caffeine, salt and sugar two weeks before your period.
Can cycles really sync?
Yes. Studies show the phenomenon tends to happen after about four months of togetherness. "Some research suggests that pheromones women release through their armpits harmonize cycles," says Dr. Hutcherson. At least you'll have someone to complain with!