Is It Menopause? Changes in Your Menstrual Cycle

Are you in menopause?

Doctor, I am 49 years old and have been taking birth control pills for many years, which has kept my menstrual cycle regular.
However, I recently noticed that my period has become very short (2 days) and the flow has decreased.
Could this be related to menopause? If I need to test my hormone levels, should I stop taking the birth control pills? How long should I stop before the test? Thank you for your response!

Dai Tai Tai, 40~49 year old female. Ask Date: 2011/12/16

Dr. Cai Yonglong reply Obstetrics and Gynecology

Dear Dr.
Tsai Yong-long of the Department of Obstetrics and Gynecology at Tainan Hospital, Ministry of Health and Welfare:
Long-term use of contraceptive pills can suppress ovarian function and may lead to an earlier onset of menopause.
It is recommended to discontinue the medication for one month and then visit the gynecology outpatient clinic for a blood test to check hormone levels.

Wishing you good health and all the best!
Sincerely,
Department of Obstetrics and Gynecology, Tainan Hospital, Ministry of Health and Welfare

Reply Date: 2011/12/16

More Info

Menopause is a natural biological process that marks the end of a woman's reproductive years, typically occurring between the ages of 45 and 55. However, the onset of menopause can vary significantly among individuals. Your symptoms, including a shorter menstrual cycle and reduced flow, could indeed be indicative of perimenopause, which is the transitional phase leading up to menopause. During this time, hormonal fluctuations can lead to changes in menstrual patterns.

The use of hormonal contraceptives, such as birth control pills, can mask some of the natural changes in your menstrual cycle. These medications work by regulating hormones to prevent ovulation and manage menstrual symptoms. Therefore, if you've been on birth control for a long time, it might be challenging to determine whether the changes in your cycle are due to the onset of menopause or simply a side effect of the contraceptive method.

To answer your question about hormone testing: if you want to assess your hormone levels to understand whether you are entering menopause, it is generally recommended to stop taking hormonal contraceptives for a period of time before testing. This allows your body to return to its natural hormonal state, which can provide a clearer picture of your hormonal balance. The duration for which you should stop taking the pill can vary, but a common recommendation is to wait at least one full cycle (about 28 days) after discontinuation before undergoing hormone testing. However, some healthcare providers may suggest waiting longer, depending on individual circumstances.

When you do decide to get tested, your healthcare provider may check levels of hormones such as Follicle Stimulating Hormone (FSH) and Estradiol. Elevated FSH levels can indicate that your ovaries are producing less estrogen, which is a common sign of approaching menopause. Additionally, other symptoms of perimenopause may include hot flashes, night sweats, mood swings, and sleep disturbances, which can further support the diagnosis.

It is also important to consider that while hormonal changes are a natural part of aging, other factors such as stress, diet, and lifestyle can also impact your menstrual cycle. Therefore, discussing your symptoms and concerns with a healthcare provider is crucial. They can provide personalized advice and may recommend lifestyle changes, alternative therapies, or other interventions to help manage symptoms associated with perimenopause or menopause.

In summary, the changes you are experiencing in your menstrual cycle could be related to the onset of menopause, particularly if you are around the age of 49. Stopping hormonal contraceptives for a period of time before testing your hormone levels is advisable to get an accurate assessment. Consulting with a healthcare provider will help you navigate this transition and address any concerns you may have.

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