Long term effect of not having menses
I'm 31 and am trying to get pregnant (my second). The problem is whenever I go off birth control (both the pill and depo- Provera) I don't have any periods and don't ovulate (Before I went on the pill I had a very irregular cycle).
When I got pregnant the first time it was exactly two weeks after I stopped taking the pill and I assumed my cycle was regulated by the pill allowing me to get pregnant. Now, the question, since I have this irregular cycle when I am not on birth control how will this affect my body long term? Over the course of my life I have frequently gone months, and even up to two years without a period. Does this do long term damage of any kind?
The problem is lack of, or infrequent, ovarian ovulation. Ovulation produces menstrual slough (if pregnancy doesn't occur each cycle).
In the long term, absent or infrequent menses can have two effects:
If there is sufficient estrogen from the ovaries such as that seen with polycystic ovarian disease, a woman has a higher incidence of endometrial cancer usually at an earlier age. In this case the usual treatment is to induce a menstrual period every 2-3 months at least so that the endometrium lining the uterus is not under constant estrogen stimulation.
If there is a lack of estrogen because the ovary is not being stimulated to produce estrogen by pituitary hormones, then a woman may be at risk for premature osteoporosis, heart disease, etc. just as if she were menopausal. This usually only happens in severe cases such as anorexia nervosa eating disorder, stress induced anovulation, severe physical or athletic activity etc.
The general category is a "hypothalamic amenorrhea". If it goes on more than a year or so, most physicians recommend some sort of estrogen replacement.
That replacement can be oral contraceptives, or, if you are trying to get pregnant, sequential estrogen/progestin. However if trying to get pregnant, often ovulation induction medicines are needed such as Clomid®.
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