Good to know : Irregular Periods Over 40: Do I Need to Worry?

What is Perimenopause?

It is the name given to the transition phase between a woman’s fully reproductive years to menopause, when you have had no period for 12 months straight. 

It can last anywhere between one to ten years and usually starts in your mid 40s, but it can begin much earlier or later. Some women will breeze right through and not notice any changes. Most women, however, will experience some kind of impact, ranging from nuisance to mild discomfort.

Apart from an irregular period, there are many other symptoms of Perimenopause. The most common include:

• Hot flushes
• Night sweats
• Difficulty sleeping
• Low mood or anxiety
• Reduced sex drive (libido)
• Vaginal dryness and discomfort during sex
• Problems with memory and concentration

Some of these symptoms can be quite pronounced, but oftentimes, women do not notice they have entered perimenopause. This is because changes are happening while your period is still regular and the symptoms can be confused with PMS (premenstrual syndrome). Having an irregular period is therefore a useful signal that your body is moving towards the end of your reproductive years.

What Causes this Change in the Body?

It mainly comes down to hormones, your body’s messengers, which travel through the bloodstream to affect various functions and processes. When a woman enters middle age, her ovaries start to produce less oestragen. They also produce less ovarian follicles making the ovaries become less responsive to Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH), two hormones necessary for reproduction and the regulation of oestrogen, progesterone and testosterone. This decline in oestragen and fluctuating hormones can be the cause of almost any imaginable bleeding pattern. This also includes intermenstrual bleeding, which is separate to irregular menstruation.

What is Intermenstrual Bleeding?

It is bleeding that occurs before or after the period rather than being part of the cycle and is another common change to your body in your 40s. However, it is always prudent to rule out dysfunctional uterine bleeding. For instance, by booking a cervical smear to rule out cervical cancer. Or an ultrasound scan of the pelvis to check the womb for uterine cancer. These diagnoses are the very worst case scenario, but it is useful to know which symptoms are a cause for concern.

When to See a Doctor 

Irregular periods and intermenstrual bleeding are completely normal during perimenopause. However, there are other conditions that might be affecting menstrual bleeding. See your doctor straight away if you notice any of the following situations:

• Your periods have blood clots or are very heavy
• Your periods are much longer than normal
• Spotting occurs between periods
• Spotting occurs after sex
• There is no sizeable gap between periods

There are many health conditions that could cause abnormal bleeding ranging from hormone problems to pregnancy and from blood clotting issues to diabetes. Some reasons could be as a result of perimenopause, such as fibroids or polyps, while others could be completely independent, like STIs, cancer or the very harmless cervical erosion.

With regard to irregular periods in your 40s, it is useful to remember that the reason could also be down to lifestyle.

Here is a list of lifestyle habits which could be affecting your period:

• Significant weight gain or loss
• Over-exercising
• Poor diet
• Smoking
• Increased stress
• Hormonal contraception

Your irregular period is most likely nothing to worry about and probably a sign of Perimenopause. However, should you feel your symptoms are a cause for concern or you have any questions at all, please feel free to ring us on 02033 030 316 for confidential advice.