Irregular Periods: Reason For Concern?

As someone who has had irregular periods her whole life, I now know all too well how important it is to speak with an OB/GYN who is also an infertility expert. I was told for years not to worry about my irregular period and was put on birth control to help regulate my cycle. Fast-forward to when I was trying to conceive, I found out I have PCOS and spent years doing fertility treatments, including six rounds of IVF to finally conceive. Had I spoken with a infertility expert, I believe, I would have known long before that I have PCOS and would have frozen my eggs years ago, knowing I would likely need IVF.

But are irregular periods always cause for concern? Not necessarily.

To find out more I spoke with Dr. Scott Dinesen of Axia Women’s Health – Dinesen & Associates OB/GYN and Infertility. Remember that no matter the case, knowledge is always power.

Momtastic: Why might a woman have irregular periods? 

Dr. Scott Dinesen: Regular periods are periods that occur between 24-31 days (from the first day of one cycle to the first day of the next cycle). Periods outside this range are considered irregular. Irregular periods could be a sign of a hormonal issue or an anatomic issue.  Hormonal issues could include thyroid dysfunction, trouble ovulating correctly, premature ovarian failure, polycystic ovarian syndrome (PCOS), hyperinsulinemia (increased insulin levels) or hypercortisolism (increased cortisol levels). Anatomic issues could include uterine fibroids, endometrial polyps, ovarian cysts, thyroid nodules or pituitary adenomas (masses).

Momtastic: Are irregular periods only a cause for concern if a woman wants to conceive? 

Dr. Scott Dinesen: All irregular cycles should be evaluated. Many are not a cause for concern, but irregular cycles could be a sign that something else is amiss in your body and deserves a check.

Momtastic: What steps should women take if they have irregular periods and want to see where they stand from a fertility standpoint? 

Dr. Scott Dinesen: Seeing a fertility specialist is important to ensure you’re getting the right tests done. Typically, it first requires a consult with your OB/GYN (if they practice fertility medicine) or a REI (reproductive endocrinologist and infertility doctor) to assess your complete medical history. Then, your provider will usually want to conduct blood work (ideally done on day 3, 4 or 5 of your cycle) that would include checking pituitary hormones, thyroid, ovarian hormones and metabolic hormones. Additionally, an ultrasound may be done on day 3 and 12 of your cycle to look at the anatomy of the reproductive organs (uterus and ovaries) and to see if you are ovulating correctly. Depending upon the results, your provider will consult with you to develop an action plan.

Momtastic: Does this still apply if a woman has no plans to conceive anytime soon?  

Dr. Scott Dinesen: It’s still important to be evaluated. Periods are a sign of what a woman’s system is doing on the inside. As discussed earlier there can be signs of thyroid disease, PCOS, diabetes, fibroids, polyps, etc. You may not be ready to be pregnant right now, or ever, but having a thyroid dysfunction, or other hormonal or anatomic conditions can affect your overall health. If all checks out and there are no issues, no treatment is required, but at least you have peace of mind that you are healthy.

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