I had regular periods before five years but after that it has become irregular. Why?

Question

Hello doctor,

I am 30 years old and married, I had regular periods, every 26 to 30 days, till five years back. After that, it became irregular and continued up to two months, from spotting to excessive bleeding. I consulted the doctor, and she prescribed me Sysron-N, which controlled the bleeding. After one month, I became normal, but I did not have periods for almost two months, then the same problem started again starting with spotting to excessive bleeding. I am taking the same medicine whenever there is excessive bleeding, but the problem is still there. I do not take any birth control pill, and also pregnancy chances are less as we take precautions. Kindly advice.

Answer 1

Hello,

Welcome to icliniq.com.

If your menses had been regular before five years, and then they became irregular presenting with intermenstrual bleed starting with spotting and then increasing to increased flow, which was controlled by Sysron-N tablet which is a progesterone, (Norethisterone). The pattern of bleeding indicates that there is progesterone deficiency during the midcycle and that causes irregular shedding of the endometrium as the secretory phase of the endometrium is not achieved in progesterone deficiency so, and there is a presence of disordered proliferative endometrial lining which is unstable and hence keeps breaking causing bleeding.

It is advised that you undergo an endometrial biopsy between day 18 to 22 and send for histopathological examination, which if turns out to be disordered proliferative endometrium, then you would have to be placed on progesterone from day 15-day 25 for 10 days each cycle for six months at least to restabilize the hormonal concentration and hence making the periods regular with stoppage of bleeding completely. You may discuss the option with your gynecologist and take an informed decision.