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Irregular periods and bone health

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August 31st, 2009
I have what I've been calling "inverse PMS". First off, I have always had an irregular period. There's typically a 2-3 month break between periods. I don't keep the best track of it. I usually bleed heavily for about 3 days with lighter bleeding after.

For about a week before my period, I become very focused. I'll feel mentally sharp, energetic, able to plan things and carry out those plans, and find it easier to complete everyday menial tasks. I generally feel like I wish I would always feel. By the first day of heavy bleeding this has all faded away into my period fatigue (I'd hibernate if allowed). From the end of my period on I feel a general sense of depression: lack of energy and focus, muddled thoughts, difficulty completing tasks or taking on projects.

The change is so dramatic it feels like I'm switching between being two different people. Any idea as to what is responsible? I worry that if I take birth control, I'll be stuck in the depressed portion of my cycle.


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replied September 1st, 2009
Menstruation Answer A7193
Thank you for your question. A gynecologist may be the best person to consult about whether or not your experience is typical or is symptomatic of something that requires intervention.


Beyond your direct question however, you note that you have "always" had irregular periods. Since you are in your mid 20s it would be a good idea to talk with your gynecologist and primary care physicians about your bone health. Regular menstrual cycles (i.e., periods once per month) are necessary for optimal bone health.


However, you may need to be evaluated medically to determine why your periods are so infrequent. Addressing any identified causes may not only regulate your cycle but may also regulate your mood and energy level.


If you are concerned about your bone health you can request a bone density test. This is a non-invasive procedure that is like getting an x-ray. Depending on your history, the most effective type of bone density test may be via a DEXA-scan. This type of bone scan evaluates your bone density in your non-dominant hip.

Best wishes,

Dr. Selby


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