Menstrual Cycle Regularity and Family History of Breast Cancer

Menstrual cycle, family history of breast cancer?

Hello, Doctor.
Based on my knowledge, I understand that the rhythm method of contraception is relatively suitable for those with regular menstrual cycles, while individuals who do not wish to become pregnant should use condoms or other doctor-prescribed methods.

1.
What is the definition of a regular menstrual cycle? How many days of variation each month is considered regular? (For example, is a variation of 3, 5, or 7 days acceptable?)
2.
Here are my menstrual periods over the past year: 36, 31, 28, 38, 34, 29, 28, 35, 30, 37, 30, 29 (with an average of 33 days and lasting 5-7 days each time).
Would I be considered regular or irregular? If irregular, is it irregular enough to warrant a doctor's visit?
3.
Based on my cycle, would it be appropriate to use the non-ovulation/safe period calculation for the 1-2 days before my expected menstruation? Or is it highly discouraged or not recommended? (Only considering the 1-2 days before the expected menstruation, not exceeding 3 days.)
4.
My grandmother, who had a stroke years ago, suddenly passed away from breast cancer last year, which developed in her armpit area.
Does this mean that hormonal contraceptive prescriptions are not suitable? (Such as birth control pills, IUDs, etc.) I believe only condoms are acceptable, and I would like to confirm this with the doctor.
Thank you for your time!

mos, 20~29 year old female. Ask Date: 2023/09/20

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your recorded irregular cycles, it is difficult to predict both ovulation and menstruation, resulting in a high failure rate for this method of contraception.
The failure rate for using condoms consistently is over 5%.
Contraceptive pills are different from hormone replacement therapy for menopause; there is no established link between contraceptive pills and breast cancer.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2023/09/20

More Info

Understanding the menstrual cycle and its regularity is crucial, especially in the context of reproductive health and family history of breast cancer. Let's break down your questions and concerns systematically.

1. Definition of a Regular Menstrual Cycle: A regular menstrual cycle is typically defined as one that occurs consistently within a certain range of days. Most cycles range from 21 to 35 days, with an average of about 28 days. A cycle is considered regular if the length varies by no more than a few days (usually 3-5 days) from month to month. For example, if your cycles are consistently between 26 and 32 days, they can be considered regular. However, if you experience significant fluctuations beyond this range, it may indicate irregularity.

2. Your Cycle Analysis: Based on the cycle lengths you provided (36, 31, 28, 38, 34, 29, 28, 35, 30, 37, 30, 29 days), your average cycle length is approximately 33 days. While there are some variations, the cycles mostly fall within a reasonable range (28-38 days). This suggests that your cycles are relatively regular. However, if you notice significant changes in your cycle length or experience symptoms such as heavy bleeding, severe pain, or missed periods, it would be advisable to consult a healthcare provider.

3. Safe Period Calculation: The "safe period" method, which relies on tracking ovulation to avoid pregnancy, can be tricky. Given your average cycle length of 33 days, ovulation typically occurs about 14 days before your next period. Therefore, the days leading up to your expected period (1-2 days before) are generally considered high-risk for conception, as sperm can survive in the female reproductive tract for several days. Thus, relying solely on the safe period method, especially just before your expected menstruation, is not highly recommended for effective contraception. It’s best to use additional methods, such as condoms or hormonal contraception, for more reliable protection.

4. Family History and Hormonal Contraceptives: Given your family history of breast cancer, particularly with your grandmother's diagnosis, it is understandable to be cautious about hormonal contraceptives. While current research does not definitively link hormonal contraceptive use to an increased risk of breast cancer, women with a strong family history of breast cancer may want to discuss their options with a healthcare provider. Non-hormonal methods, such as condoms, are indeed a safe alternative if there are concerns about hormonal influences on breast cancer risk. It’s crucial to have a personalized discussion with your doctor about the best contraceptive method for your situation, considering both your family history and personal health.

In summary, your menstrual cycle appears to be relatively regular, but if you have concerns about its consistency or any associated symptoms, consulting a healthcare provider is wise. Regarding contraception, while the safe period method can be used, it is not the most reliable form of birth control, especially close to your expected period. Given your family history, discussing contraceptive options with a healthcare provider is essential to ensure you choose the safest and most effective method for your needs.

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