Managing Irregular Menstruation and Menopause Symptoms: A Guide

Irregular menstrual cycles and menopause?

I lost about 15 to 18 kg over the course of a year, but since then, my menstrual cycle has been irregular, and I often need to visit a gynecologist for medication to induce menstruation.
Once I started taking menstrual regulation medication, my cycle became normal again.
However, this year, I gained about 6 kg in six months, and my menstrual irregularities returned, requiring me to take medication to induce menstruation once more.
I am quite frustrated because I am currently seeing a nutritionist at Chang Gung Memorial Hospital to adjust my diet for weight loss, but I am worried that if I lose weight again, my menstrual cycle will become irregular once more.
What should I do to normalize my menstrual cycle?
Additionally, my mother is experiencing menopause and has osteoporosis, which requires her to take female hormones to improve her condition.
However, after starting the hormones, she began to feel unwell, so she stopped taking both the female hormones and the osteoporosis medication.
She also has trouble sleeping at night, experiences a feeling of tightness in her chest, and feels discomfort when swallowing hard foods, which causes discomfort from her throat to her chest.
We have visited various hospitals in the southern region for health check-ups, but everything appears normal.
We are unsure how to resolve these issues and what might be causing them.

ANNE, 20~29 year old female. Ask Date: 2000/11/18

Dr. Lin Zhaopei reply Obstetrics and Gynecology

From your letter, it seems that the irregular menstrual cycle you are referring to may be due to an extended menstrual cycle.
Rapid weight loss can lead to insufficient secretion of pituitary hormones, resulting in missed periods.
Conversely, weight gain and obesity can sometimes increase the secretion of male hormones, which can also cause missed periods.
Additionally, emotional distress and high stress levels can be quite troubling for you.

A simple approach would be to consult a gynecologist for menstrual induction medication if you haven't had a period for two months.
If you are planning to conceive or want to take a more proactive approach, it would be beneficial to relax, maintain a stable weight, and consider taking oral ovulation medications, as having ovulatory menstrual cycles can help regulate your periods.
Symptoms of menopause include hot flashes, night sweats, insomnia, palpitations, frequent urination, mood swings, irritability, vaginal dryness, and pain during intercourse.
In advanced stages, there may also be an increase in blood lipids and osteoporosis.
Taking estrogen may cause side effects such as nausea, bloating, breast tenderness, vaginal swelling, weight gain, and even vaginal bleeding.
Hormone therapy can be administered through injections, topical creams, or oral medications, with various options available for oral medications.
It is difficult to determine which specific discomfort you are experiencing based on your letter, so I recommend discussing your situation in detail with your healthcare provider.

Reply Date: 2000/11/18

More Info

Managing irregular menstruation and menopause symptoms can be quite challenging, especially when compounded by weight fluctuations and other health concerns. Let's break down your situation and explore potential strategies for managing these issues effectively.

Irregular Menstruation
Irregular menstruation can be influenced by various factors, including weight changes, hormonal imbalances, stress, and underlying health conditions. In your case, the significant weight loss of 15-18 kg over a year likely disrupted your hormonal balance, leading to irregular cycles. When you regained some weight, your menstrual cycle became irregular again, indicating that your body is sensitive to these changes.

1. Weight Management: Since you are already working with a nutritionist to adjust your diet, it’s crucial to maintain a balanced approach to weight management. Rapid weight loss or gain can lead to hormonal fluctuations. Aim for gradual changes in your weight, ideally losing or gaining no more than 0.5 kg to 1 kg per week.

2. Regular Exercise: Incorporating regular physical activity can help regulate your menstrual cycle. Aim for a mix of cardiovascular, strength training, and flexibility exercises. Exercise can help manage weight and reduce stress, both of which can positively impact your menstrual health.

3. Stress Management: High stress levels can also contribute to irregular periods. Consider incorporating stress-reducing practices such as yoga, meditation, or mindfulness into your routine. These practices can help balance your hormones and improve overall well-being.

4. Consultation with a Healthcare Provider: Since you have been using hormonal medications to regulate your cycle, it’s essential to continue discussing your symptoms with your gynecologist. They can help determine if you need further hormonal evaluation or if there are alternative treatments available.

Menopause Symptoms
Regarding your mother’s experience with menopause and osteoporosis, it’s important to approach hormone replacement therapy (HRT) with caution, especially if she experienced discomfort while taking it. Here are some considerations:
1. Alternative Therapies: If HRT is not well-tolerated, there are alternative treatments for managing menopause symptoms. These can include lifestyle changes, herbal supplements (like black cohosh or evening primrose oil), and non-hormonal medications that can help alleviate symptoms such as hot flashes and mood swings.

2. Bone Health: For osteoporosis, it’s crucial to focus on calcium and vitamin D intake, along with weight-bearing exercises to strengthen bones. If your mother is hesitant about HRT, she should discuss other medications that can help improve bone density, such as bisphosphonates or denosumab, with her healthcare provider.

3. Sleep Issues: Difficulty sleeping is common during menopause. Encourage your mother to establish a regular sleep routine, avoid caffeine and heavy meals before bedtime, and create a comfortable sleep environment. If sleep disturbances persist, she may benefit from discussing sleep aids or behavioral therapies with her doctor.

4. Digestive Discomfort: The discomfort when swallowing hard foods may be related to esophageal motility issues or other gastrointestinal concerns. It’s advisable for her to consult a gastroenterologist to rule out any underlying conditions and receive appropriate dietary recommendations.

Conclusion
In summary, managing irregular menstruation and menopause symptoms requires a holistic approach that includes weight management, regular exercise, stress reduction, and open communication with healthcare providers. For both you and your mother, it’s essential to tailor your strategies to your individual health needs and preferences. Regular follow-ups with your healthcare providers will help ensure that you both receive the necessary support and adjustments to your treatment plans as needed.

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