Irregular periods and hormone imbalance

A large number of our patients come to us with irregular periods, who commonly complain about: irregular periods, missing periods, uncertain or missing ovulation, dryness underneath, hot flashes, night sweats, prolonged bleeding, and mood swings, among other symptoms associated with missing periods.

What causes irregular periods?

Hormonal imbalance is, by far, the main reason why women have irregular periods.

Some of our patients will have already done some hormone tests and had found out this is why they had been having irregular periods. Those who haven’t get them done after consulting us.

Hormonal imbalance that impacts periods mainly takes on one of two forms:

  1. High FSH and low oestradiol
    The single most important reason for irregular periods is high FSH. When FSH goes up, a woman’s periods are likely to change. When her FSH level is higher than 25, she is likely to find her periods becoming highly irregular or missing.
  2. PCOS (polycystic ovary syndrome)
    PCOS is a condition caused by hormonal imbalance, where one of the major symptoms is irregular or missing periods. The two hormone markers for PCOS are AMH and testosterone: Women with PCOS have either have elevated levels of one or both of these hormones. PCOS tends to be vastly underdiagnosed; one main reason may be that AMH and testosterone tests results are often misinterpreted (see the blog on PCOS where we explain why in more detail).

Other hormone imbalances can include high prolactin, which can suppress ovulation, and both hypo- and hyperthyroidism, which can disrupt or suppress ovulation.

Does stress impact periods?

There is evidence to suggest that stress can suppress circulating gonadotropins and gonadal steroid hormones, which then disrupts the normal menstrual cycle. In extreme cases such as prolonged exposure, stress can lead to the complete impairment of reproductive function.

Our clinical experience seems to support this: Patients who come to us who have had no periods for a long time have reported they had experienced extreme stress, such as a loved one’s death.

Do irregular periods mean menopause?

The short answer is: not necessarily.

Patients who have highly irregular or missing periods tell us that their doctors did some tests on them and found that their FSH is high. Many are told, straight away, that they have premature primary ovarian failure: They are told they are premature because they have not reached the common age for menopause, which is 51; some of our patients as young as in their late 20s were (incorrectly) told they were going into ovarian failure. Upon diagnosis, hormone replacement therapy (HRT) is routinely offered.

Upon further investigation, we found that many of our patients who’ve gone through this are under 40, and that more than half of them still have periods — albeit highly irregular, typically every 2 to 3 months.

As, technically, menopause is defined as someone who has not have periods for 12 months consecutively, it seems clear that this criterion is not always followed. When the diagnostic protocol hasnot been followed, it can be argued that the woman in question may not have primary ovarian failure: It is the diagnosis that seems to be premature.

Patients reported that the diagnosis made them feel anxious, even depressed. Many struggled to understand how they ended up having menopause so early, despite healthy eating and living. Those who aspired to have children were devastated by the diagnosis, and their doctors advised donor eggs.

As long as one has periods now and again and/or one is under 40, it is unlikely that the woman in question has primary ovarian failure. Ultimately, we have to look beyond a diagnostic label that may or may not be correct. The more important questions we think worth asking are: Would these irregular periods impact fertility? Can irregular periods be treated?

Why irregular periods are a problem for fertility

Irregular periods are a problem for fertility because irregular periods are largely caused by hormonal imbalance, as this affects egg quality, which is the most important factor of female fertility. When hormones are at the right levels and are balanced, egg quality is likely to also be good — and good egg quality indicates good hormone levels.

In other words, irregular periods are strongly associated with poor egg quality because both are caused by hormonal imbalance at the same time.

Besides poor egg quality, when a woman has irregular periods, she is more likely to miss some ovulations. At the very least, her ovulation timing becomes uncertain, making timely intercourse (to increase fertility chances) more difficult, or impossible. She may have dryness underneath, making intercourse painful or unpleasant. She may have low libido, too, making intercourse less frequent.

Can irregular periods be treated?

Western medical treatment

Western medical treatment tends to focus on regulating periods using some forms of contraceptive, including IUD. This clearly poses problems if one wants to have children. Some doctors may prescribe ovulation induction medication such as Provera. However, since hormonal imbalance is the cause of irregular periods, the quality of the egg that comes out is still poor as the root cause hasn’t been addressed, rendering successful pregnancy unlikely. Last, but not least, all these measures are temporary fixes — they cannot be used for too long. More importantly, they do not tackle the root course of the problem, namely, hormonal imbalance.

Would supplements help?

Nearly all of our patients who come to us are already taking an array of supplements. The fact that patients still come to us seems to show that the supplements they take have not helped them regulate their periods.

Another problem with supplements is that patients usually take quite a number of them. Few, including those who market the supplements, can tell us what happens when they’re mixed together. We have seen some patients’ periods get worse as a result of taking a cocktail of supplements.

The bottom line is there seems little evidence that supplements can change hormones for the better. If they cannot do that, we know it will have little impact on irregular or missing periods.

Chinese medicine

At TCM Healthcare, we focus on the key issue: egg quality. Since some key reproductive hormones are strongly associated with egg quality, this means that if these hormones are improved, egg quality also improves. That’s what we do at TCM Healthcare: We help women improve their egg quality by improving their hormones, through prescribing herbal medicine in our traditional Chinese medicine practice.

Our protocol is to obtain up-to-date hormone test results first. These tell us what exactly the problems are — which hormones are out of sync. They also serve as baseline measures for patients to check progress after a few months of treatment. In over 80% of cases, our patients’ hormones improved and their periods came back, or got better, as a result. By definition, their egg quality also improved and many went on to have successful natural pregnancies. You can read some of their stories here. For more stories about opur patients, please click testimonials.

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Late cancellation fee £50
We appreciate that you might not be well or have urgent matters to attend. As a result you may have to postpone the appointment. We would like to have at least 24 hours’ advance notice. A late cancellation fee of £50 is payable if advance notice is not given.

Are there patients we cannot help?

Yes. No medical system is foolproof and medical practitioners, however good, are not omnipotent. As great as our success rates are, they are not 100%. There are times patients do not respond to our treatments despite our best efforts.

Delayed improvements are possible when patients rest a little. However, even with rest, patients may still not respond well. Fortunately, these cases are in the minority. We minimise the number of these cases by trying to understand our patients’ conditions as much as possible before taking them on. We minimise time and financial commitments from patients by insisting they have hormone or sperm test results prior to treatment, and to get retested after 3 months — following our evidence-based approach.

At TCM Healthcare, we will always have your best interests in mind and we will do our best.