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Irregular Menstrual Cycle
August 2001

Q. I am a 29-year-old African American woman. I have had one pregnancy which resulted in a twin birth. I have always had painful and irregular cycles. I have about 4 cycles a year and bleed each cycle from 10 - 21 days. I can't take birth control pills due to the awful reaction I have to them. I have thyroid test, sonograms, pelvic exams, etc. Nothing found. Should I be concerned? Is it important to have a certain number of cycles a year?

A. It sounds like you have had a thorough evaluation of the situation described. If there is no underlying reason for the irregular menses, the question of concern is a good one. With prolonged interruption of the menstrual cycle, for example longer than 6 months, there can be loss of bone strength as estrogen plays a role in bone metabolism. This is a common concern in certain athletic groups where menstrual disturbance is common, and occurs commonly with eating disorders. The loss of bone strength in the hip, spine, and elsewhere can be severe enough to lead to osteoporosis and stress fractures. Four cycles per year is probably enough to protect you from this, but a bone density test could be done to assess matters further.



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