Menstrual Irregularities: Causes and Treatment Options

Q: Menstrual Irregularities: Causes and Treatment Options

Hello： 1. Provera is a progestin, not an estrogen; its function is to suppress estrogen. 2. Any medication may have potential side effects, and Provera may cause fluid retention, which could lead to slight changes in weight. 3. You are welcome to bring the pat

Menstrual irregularities

1.
My menstrual cycle has always been regular (28 days) and lasts for 7 days.
However, in October 2005, I suddenly experienced abnormalities.
From the start of my period until it completely ended, it lasted a total of 15 days (with a lighter flow than usual).
I did not have a period in November, and in December, from the start of my period until it completely ended, it lasted 25 days (with a light flow for the first 15 days and a heavier flow for the last 10 days).
In January 2006, my period lasted for 19 days (with a light flow for the first 10 days followed by a heavier flow).
2.
On February 14, 2006, I went to the hospital for a transvaginal ultrasound, and the doctor diagnosed me with endometrial hyperplasia.
A dilation and curettage (D&C) procedure was performed.
In March 2006, my cycle returned to normal with normal flow.
In April 2006, my cycle was normal but lasted for 17 days (with a light flow for the first 12 days and a heavier flow for the last 5 days).
On May 25, 2006, my cycle was irregular, lasting only 2 days (with very light flow).
From June 2 to June 23, 2006, my period lasted until it ended (with a very heavy flow for the last 5 days).
On June 23, I sought medical attention again and had another transvaginal ultrasound, where the doctor again diagnosed me with endometrial hyperplasia.
I was prescribed female hormones (M135 Provera 5mg/tab) to take 4 times a day for 14 consecutive days, after which I stopped taking them.
On July 14, 2006, my period lasted for 8 days (with a heavy flow for the first 3 days and a lighter flow for the last 5 days), and since August 3, my flow has been light.
3.
During my consultations, I asked two doctors about the cause of my symptoms, and they suggested that it might be due to work-related stress and not indicative of menopause.
My question is: Do I need to rely on taking female hormones for my menstrual cycle and flow to return to normal as it was before? Are there other methods? Also, will taking female hormones cause weight gain? (I have gained 2 kg since starting the hormones.) Thank you for your assistance.

zhāngyú, 40~49 year old female. Ask Date: 2006/08/08

Dr. Li Guanghan reply Obstetrics and Gynecology

Hello: 1.
Provera is a progestin, not an estrogen; its function is to suppress estrogen.
2.
Any medication may have potential side effects, and Provera may cause fluid retention, which could lead to slight changes in weight.
3.
You are welcome to bring the pathology report from your uterine curettage to Dr.
Lee's clinic at Hsinchu Hospital, Department of Obstetrics and Gynecology.

Reply Date: 2006/08/08

More Info

Menstrual irregularities can be a source of concern for many women, and understanding the underlying causes and treatment options is essential for managing these changes effectively. Based on your description, it appears that you have experienced significant fluctuations in your menstrual cycle, including changes in duration and flow, which have been diagnosed as endometrial hyperplasia.
Endometrial hyperplasia is a condition characterized by the thickening of the uterine lining, often due to an imbalance in estrogen and progesterone levels. This condition can lead to irregular menstrual cycles, as you have experienced. The fact that you have been prescribed hormonal therapy (Provera) suggests that your healthcare provider is attempting to regulate your menstrual cycle and address the hyperplasia by providing the necessary hormones to balance your cycle.

Causes of Menstrual Irregularities
1. Hormonal Imbalances: Fluctuations in estrogen and progesterone can lead to irregular cycles. This can be influenced by stress, weight changes, and other lifestyle factors.

2. Stress: As mentioned by your doctors, stress can significantly impact your menstrual cycle. High levels of stress can disrupt the hypothalamus, which regulates the hormones responsible for menstruation.

3. Medical Conditions: Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, and uterine abnormalities can also cause irregularities.

4. Age: As women approach menopause, hormonal changes can lead to irregular periods.

Treatment Options
1. Hormonal Therapy: As you are currently taking Provera, this is a common treatment for endometrial hyperplasia. It helps to regulate the menstrual cycle and reduce the risk of further hyperplasia. It is important to follow your doctor's instructions regarding the duration and dosage of this medication.

2. Lifestyle Modifications: Managing stress through relaxation techniques, exercise, and a balanced diet can help regulate your menstrual cycle. Maintaining a healthy weight is also crucial, as both underweight and overweight conditions can affect hormonal balance.

3. Monitoring and Follow-Up: Regular follow-up with your healthcare provider is essential to monitor the effectiveness of the treatment and make adjustments as necessary. This may include repeat ultrasounds or endometrial biopsies to assess the uterine lining.

4. Alternative Treatments: Some women find relief through herbal supplements or acupuncture, but it is essential to discuss these options with your healthcare provider to ensure they do not interfere with your current treatment.

Concerns About Weight Gain
Regarding your concern about weight gain while on hormonal therapy, it is not uncommon for some women to experience changes in weight due to hormonal treatments. Progestins, like Provera, can lead to fluid retention and increased appetite in some individuals. If you are concerned about weight gain, discuss this with your doctor. They may suggest dietary modifications or alternative treatments that may have a lower risk of weight gain.

Conclusion
In summary, while hormonal therapy is an effective way to manage your menstrual irregularities and endometrial hyperplasia, it is essential to consider a holistic approach that includes lifestyle changes and regular monitoring. If you have concerns about the side effects of your medication or the effectiveness of your treatment, do not hesitate to communicate openly with your healthcare provider. They can provide personalized advice and adjustments to your treatment plan to help you achieve a more regular menstrual cycle and overall well-being.

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