Changing Periods

Kelly Anne Spratt, D.O., Director of Women's Cardiovascular Health at the University of Pennsylvania Presbyterian Medical Center, answers your questions.

Q. For the last two years my periods have changed. I used to be very regular. Every 28 to 30 or so days. Starting two years ago, it has been a few days shorter, though sometimes it will be the normal 28 or so. Is there something wrong? I am 35.

A. You are experiencing what is known as perimenopause, a time that can be likened to puberty in reverse. It is common that as a woman ages, usually starting 8 to 10 years before menopause, there are changes in her period often reflected by differences in either the length of her cycle or the amount of flow. This is due to a decline in function of the ovaries and of estrogen production.

This drop of estrogen causes many symptoms, among them a change in your periods. This change is normal, and is noted by a shortening cycle length, at first by two or three days, then becoming irregular and the duration and intensity of menstrual flow will start to vary. Some cycles will produce heavy bleeding, while others will be scant. If you find these changes to be uncomfortable, see your gynecologist. Your doctor may prescribe low-dose birth-control pills to help control the symptoms and to regulate your periods.

The perimenopausal period is a great time to "get ready" for menopause, a period during which certain health issues such as osteoporosis prevention and heart disease risks need particular attention so that they do not become long term issues later. Now is a good time to make sure you've got a regular exercise program you can stick with for the rest of your life, and to make sure your weight, cholesterol, and blood pressure are all under control.