Until you’re trying to get pregnant, you may not care if your period isn’t completely regular. In fact, the only problem you might be aware of is occasional cramps. But things change when you’re trying to conceive.
As part of the menstrual cycle, necessary for human reproduction, the uterine lining prepares itself to receive and nourish a fertilized egg. When fertilization doesn’t happen, the lining sheds: menstruation. Most women begin having periods by age 16, and continue having them until around age 50. The bleeding happens approximately every 20 to 40 days like individual clockwork: biological clockwork.
But sometimes the body’s reproductive clock doesn’t keep the right time. “It’s all about looking at change,” says Susan Wysocki, RNC, NP, FAANP, president and CEO of the National Association of Nurse Practitioners in Women’s Health (NPWH). “If there’s a change in the bleeding pattern,” she continues, “it’s sometimes an indication that something’s up.” Periods may become irregular, infrequent, or stop altogether. And when that happens, especially when you’re trying to get pregnant, it’s time to see a doctor.
Here are some common period problems, and what to do about them:
This is the medical term for the absence of menstruation, i.e., no periods. Primary amenorrhea is diagnosed when a girl doesn’t get her first period by the age of 16. Menopause is a permanent amenorrhea. But when a woman previously had periods, but then goes for six months without having one, it’s called secondary amenorrhea. Pregnant and breastfeeding women experience secondary amenorrhea temporarily. “For someone not on birth control,” explains Wysocki, “amenorrhea is often a sign that they are not ovulating, not producing an egg.” A woman who stops having periods without explanation needs to be medically evaluated.
“If a woman isn’t pregnant or in menopause, then lack of a period may be anatomical or hormonal,” says Lee P. Shulman, MD, professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine in Chicago. One cause of amenorrhea is a lack of body fat; women who are too thin, or who have poor nutrition, may not menstruate until they reach a healthy body weight or take in sufficient nutrients. “A little bit of fat is important for health and well being,” explains Dr. Shulman.
This is the term for intermittent periods, when a woman’s cycle is irregular, skipping one or more periods. Irregular cycles are normal for young women just beginning to menstruate, and for older women nearing menopause. But irregular periods in women in the midst of their reproductive years may be a sign of a hormonal problem. According to Wysocki, oligomenorrhea “can also be indicative of underlying health problems such as polycystic ovarian syndrome, and may signal other problems such as hypertension or diabetes.”