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Ask the Medical Expert Archives 2000-2004

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Shortened Menstrual Cycle
July 2000

Q. I am experiencing a shortened menstrual cycle - bleeding approximately every 10 to 20 days, for the full 4-5 days each time, as well as experiencing some spotting in between these periods. The spotting is very light. I am currently taking a continuous use pill without estrogens, and have been on it for the last 5 months. I also, experienced this about 10 months ago, but I wasn't using any form of oral contraceptive then. At that time, it lasted for 8 weeks (ie, 4 periods) and then stopped, or had my cycle lengthened again. I did see a health care professional about this the first time, but he was of the opinion that as long as it was regular, there was no cause for alarm about frequent periods. Any advice would be greatly appreciated.

A. Your menstrual problem involves two different elements. First, you're having more frequent periods than is average and second, you spotting in between the periods. The one thing that I cannot get a good sense of from your letter is if the bleeding is heavier than normal. Even without this information, however, we should be able to come up with some answers.

The normal menstrual cycle includes a rhythmic variation of your estrogen and your progesterone. In essence, the estrogen plants the seeds for the new lining of your uterus each month, followed by the progesterone that acts like a fertilizer. At the end of the cycle, both the estrogen and the progesterone drop, and the lining that had developed over the past few weeks leaves the body as a menstrual period. Then the whole cycle repeats. It sounds as though you are on a progesterone only pill. The complications of this kind of single therapy are the kind of side effects that you are having.

My recommendation is to have a health care provider to evaluate whether you would be a candidate for either one of the newer birth control pills, a non-pill form of contraception, or (if you do not need a birth control method at this time) stopping all the medications for now.

Additional information on the menstrual cycle and options for contraception can be found at: http://www.womens-health.com/GynHealthCenter/gyn_repro_menstrual.html and at: http://www.plannedparenthood.org/bc/

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