From hormonal changes, pregnancy, and weight gain to stress and excessive exercise, irregular periods can occur due to various reasons. It can sometimes also indicate underlying medical conditions like endometriosis, Polycystic Ovary Syndrome (PCOS), and uterine or ovarian cancer, which is why consulting a doctor is the best way to know for sure.
However, when you start having irregular menstruation in your 40s, experts suggest that it could be a sign of perimenopause, also called the menopausal transition.
Also Read: Premature Menopause: Understanding Health Risks And Symptoms To Watch Out For
What Is Perimenopause?
Different women experience perimenopause at different ages. In an interaction with the OnlyMyHealth team, Dr Neha Gudara, Consultant Gynaecologist, Manipal Hospital, Jaipur, says, "Perimenopausal age begins often in women aged 40–44 years of age and is marked by changes in the menstrual flow and in the length of the cycle."
The World Health Organization (WHO) defines perimenopause as the transitional phase that begins when the first signs of menopause appear and continues until one year after the final menstrual period.
The onset of perimenopause may vary from one woman to another, with some experiencing it in their 40s, while others may begin earlier or later, depending on individual factors.
Can Irregular Periods In The 40s Indicate Perimenopause?
During the menopausal transition, the menstrual cycle becomes irregular; it may either be delayed or occur more frequently, according to Dr Gudara.
She adds that menstrual bleeding can vary, being either scanty or excessively heavy, both of which are associated with the perimenopausal stage.
"This occurs due to sudden fluctuations in hormone levels, particularly oestrogen. About six months before menopause, oestrogen levels drop significantly, which triggers common symptoms such as hot flashes, vaginal dryness, mood swings, and weakness in women," the doctor explains.
According to the WHO, menopause is considered to have occurred when a woman has gone 12 consecutive months without menstruation, with no other clear physiological or pathological causes, and without any clinical intervention.
Other Symptoms To Watch Out For
When oestrogen levels drop in the body, especially during the menopausal stage or perimenopause, one is likely to experience other symptoms, such as:
- Hot flashes
- Night sweats
- Heart palpitations
- Vaginal dryness
- Pain during sexual intercourse
- Increased urinary incontinence
- Difficulty sleeping or insomnia
- Changes in mood
- Depression and/or anxiety
Management Tips
"Whenever women experience irregularities in their periods, they should always consult their gynaecologist or physician and get themselves investigated to differentiate between the perimenopausal symptoms and the symptoms caused by other hormonal issues," says Dr Gudara.
She adds that women can manage these perimenopausal symptoms by adopting a healthy lifestyle, which includes a healthy diet full of proteins, essential fatty acids, and other nutrients rich in isoflavones, especially soya.
Secondly, the doctor advises that women should adopt a healthy lifestyle, which includes exercises such as yoga or walking. Additionally, stress levels should be effectively managed, and women should aim to get adequate amounts of sleep.
In the end, Dr Gudara also advises getting screening tests like pap smears, breast examinations, mammography, ultrasonography, and various other vitamin deficiency tests, especially if one experiences any deviation from their regular menstrual cycle.