Most women have around 500 periods before they reach menopause. But not everyone’s cycle is the same, and periods can become irregular or stop completely well before a woman reaches this stage of life. If they do, and you know there’s no risk of pregnancy, it should be investigated.
“If your periods are erratic or you haven’t had a period for more than three months, see your GP,” says Dr Elizabeth Farrell, a consultant gynaecologist at Jean Hailes for Women’s Health in Melbourne. “Many women tend to let this situation go and simply put it down to stress. But don’t just leave it. Have a check-up,” Dr Farrell says.
Here we look at some reasons behind missing periods:
1. Polycystic Ovary Syndrome (PCOS)
PCOS is the most common hormonal disorder, affecting 12 to 18 per cent of Australian women of reproductive age. And around 70 per cent of women aren’t aware they have it.
The main symptoms of PCOS include irregular periods, excess facial and body hair, acne, weight gain and ovarian cysts. If left unmanaged PCOS can lead to long-term health problems, including type-2 diabetes or difficulty conceiving.
There’s a genetic link to developing PCOS too. “We don’t know exactly why some women get PCOS but if you have a close female relative with the disorder you have up to a 50 per cent chance of having it, too,” says Dr Farrell.
What to do: If you suspect you may have PCOS see your doctor. There is no single test to diagnose the disorder but you may be referred to have an ultrasound to detect ovarian cysts, a blood test to check hormone levels or a glucose tolerance test. PCOS treatment may include the pill and medication to manage hormones or a diet and exercise regime to lose weight.
2. Premature menopause
Almost one in 10 women will experience premature menopause before the age of 40. Also known as premature ovarian failure, the condition occurs when a woman’s suddenly stops ovulating, tragically leading to infertility.
For the majority of cases it’s still not known why premature menopause occurs. “Periods become irregular and then stop and for 60 per cent of women, we have no idea why,” says Dr Farrell.
While it can take up to six months to diagnose premature menopause there are a number of symptoms to look out for. “Women may experience hot flushes, night sweats, sleep disturbance and vaginal dryness,” Dr Farrell says.
Maintaining a healthy diet and lifestyle, keeping cool and avoiding spicy foods and smoking, are recommended ways to manage the symptoms.
What to do: Women who go through premature menopause are at greater risk of health problems such as osteoporosis and cardiovascular disease. Therefore a doctor may advise treatment, at least until women reach menopausal years. “If there are no contra-indications, hormone replacement therapy (HRT) is the treatment of choice,” Dr Farrell says.
3. Thyroid Dysfunction
An overactive thyroid (or hyperthyroidism) can lead to irregular periods, increased heart rate, sweating, difficulty sleeping, weight loss, hair loss and muscle weakness. It’s most common in women from 20 to 40 years of age.
“Sometimes it just happens. Sometimes it’s due to a nodule in the thyroid that causes the gland to be overactive and produce excess thyroid hormone. Some auto-immune disorders also trigger it,” says Dr Farrell.
What to do: If you experience any of these symptoms, see an endocrinologist. A blood test will confirm an overactive thyroid, and if so, medication will be prescribed to reduce thyroid hormone production.
4. Weight loss and over-exercising
While obesity can have a negative effect on menstruation so can weight loss. A sudden loss of weight, due to illness, an eating disorder or unhealthy dieting, can cause a woman’s menstruation system to shut down. Weighing 15 per cent less than the normal body weight for your age and height causes a reduction in the body’s fat stores. This then reduces thyroid levels and increases the stress hormone, cortisol which has a direct affect on the reproductive hormones in the body, disrupting or stopping periods.
“Periods may return to normal if you regain weight, but the longer the periods have stopped the more difficult it is for them to come back,” says Dr Farrell. “Intense exercise can also affect periods because hormone levels are disrupted in a similar way.”
What to do: If periods are affected after an extreme or sudden weight loss medical advice should be sought as soon as possible.
Some medications to treat depression, hizophrenia and taking the pill for long periods of time can stop periods. “If you skip the sugar or placebo pills and just take the active pills your period can stop immediately, but there are no ramifications with that,” says Dr Farrell. “Once you come off the pill, it can vary as to when your period comes back regularly but for most women, periods return within six months.”
What to do: If you stop taking the pill and your periods haven’t returned within six months, see your GP for a check-up. Don’t stop taking medication prescribed for any mental health issues. Again, talk to your specialist about any side effects, such as irregular periods.
While there’s no hard evidence to support the idea that stress disrupts periods, Dr Farrell believes it can happen. “My gut feeling is that in some women who experience major stress, their periods can change,” she says.
What to do: Recognise what’s causing you stress and work out ways to relax. Try meditation, exercising regularly or see a counsellor or find some stress management that works for you.
Read more stories like this: Early signs of PCOS most of us are missing. Plus, How women are ditching their periods for good.
If you are concerned about your health, book an appointment with your GP, who will be able to advise a correct treatment plan.