The majority of women become familiar with irregular periods during their forties and fifties. Perimenopause - the years just prior to menopause - is characterized by hormonal changes that can continue for up to ten years. Estrogen and progesterone levels fluctuate and become imbalanced which causes periods to become irregular, with several months often passing between menstrual bleeding. Irregular periods can cause bleeding to be heavier than normal with painful cramping, among other symptoms.
Estrogen and progesterone are the hormones that dictate the menstrual cycle. Estrogen causes the uterus wall lining to thicken prior to a period, and progesterone controls the shedding of this lining (i.e., the occurrence and duration of a period).
During perimenopause, hormonal imbalances mean periods are triggered less frequently. This causes the uterine lining to build up, so when periods occur, there is more to be shed, resulting in heavy bleeding. Painful cramps often occur in the abdomen and lower back during this time as the uterus contracts to shed. Menstrual cramps can range from mildly distracting to debilitating cases, known as dysmenorrhea, where painful cramping seriously inhibits normal life.
Heavy bleeding a cramping during a period can cause sluggishness and salt and sugar cravings. Though foods such as chocolate, cakes, and chips may satisfy these cravings temporarily, they often exacerbate sluggishness in the long run and increase water retention. This may cause the stomach to protrude, or become bloated. Some women report to temporarily gain up to eight pounds during heavy perimenopausal periods.
During a period, estrogen and progesterone fluctuations can cause the ducts in the breasts to become enlarged, resulting in swollen, tender breasts that are painful to touch. During perimenopause, when heavy, irregular periods occur, breast swelling is often more intense than in previous years.
The effects of irregular periods upon the body are not limited to physical ones. Mood swings and increased irritability around the time of your periods is a common symptom of premenstrual syndrome (PMS). This can occur at any point in a woman's life, but extreme changes in mood occur more noticeable during perimenopausal irregular periods.
While heavy, painful, irregular periods are an unpleasant part of perimenopause, perimenopausal symptoms can last for up to ten years. One way to cope is to always carry sanitary wear in your handbag to avoid being caught unaware by periods. As with most menopause symptoms, following a healthy, balanced diet, drinking plenty of water, and exercising regularly will go a long way in relieving your discomfort.
- Hutchinson, Susan M.D. "The Stages of a Woman's Life: Menstruation, Pregnancy, Nursing, Perimenopause, Menopause". November 2007.
- Love, Susan M.D. Menopause and Hormone Book. New York: Three Rivers Press, 2003.
- BMJ Group. "Menopause: What is it?" Patient Leaflet. 2007