Is Your Period Late? It Might Not Mean Pregnancy; It Could Mean Cancer!

by Dr. Adam Rosenthal

Most women on contraception (or even those who aren’t) don’t worry too much if their period is slightly irregular. Early, late, a bit heavier, lighter or maybe with big pauses between periods… everybody’s body is different. It’s probably just your hormones reacting to the drugs, right? Wrong! Sometimes it may be something far more sinister.

Most women who don’t want become pregnant take forms of contraception such The Pill, hormonal injection, implant and so on, which pause ovulation. At school, we learn that when a woman has her period, the bleeding represents the shedding of the womb lining, and with it any non-successfully embedded eggs. With most forms of contraception, the woman will still bleed monthly; however, sometimes women don’t. In these scenarios, it’s important to consult your GP for advice on regulating your period – not only incase you want to have children later (nobody likes having their period so you may be happy it’s lessened but, actually, it will impact your future fertility so it’s best to ensure it’s functioning well now) but also because it’s vital for maintaining a healthy reproductive system and ensuring that your womb lining has a constant regeneration of fresh healthy blood cells and doesn’t become too thick.


Why is my period irregular?    
The most common contributors to an irregular period are stress; being obese or underweight; hormonal imbalances and Polycystic Ovarian Syndrome (PCOS). However, an irregular period can also be a cause- and consequence- of endometrial cancer (i.e. cancer of the womb lining), which is why it’s so important to seek advice from your doctor as soon as possible.

It doesn’t just affect you. It could also mean that you are pregnant…
A common misconception is that, if you have cancer or your period is irregular, you can’t get pregnant but that’s not the case at all. Not only is it possible to get pregnant with an irregular period – you’re still ovulating, however irregularly it may be and so fertilisation can still occur! - but it’s also possible to become pregnant during the early stages of cancer. Most gynaecological cancers won’t felt by the woman until they are advanced and large enough to start pressing on the surrounding structures; and, occasionally, we see tragic cases where the woman’s cancer is only discovered when she is pregnant or has just delivered the baby.

The other symptoms of the cancer are terribly vague (e.g. bloating, abdominal pain, pelvic pain, feeling full, indigestion etc.) and can easily be brushed off as something benign. That can lead to late diagnosis, which is why it’s so important to participate in routine smear tests and to be aware of minor changes to your body – to know what’s normal for you - and if your period is late, don’t be embarrassed to seek advice.
 

Did you know… The biggest risk factor for endometrial cancer is obesity?


How can I regulate my period?
If your menstrual cycle is excessively light, irregular with big gaps in between cycles, or has ceased completely, it may mean that you are overweight or underweight.

  • If you are underweight, your GP may recommend eating more healthily and to increase your calorie intake whilst he/she monitors how long it takes for your period to resume, perhaps even to work with a dietician.
     
  • If you’re a healthy weight, they may prescribe estrogen creams, estrogen pessaries or tablets, which will restore the natural hormonal balance and induce ovulation in a similar way to what happens during IVF treatments.
     
  • If you are overweight, your doctor will advise you to lose weight and monitor your progress. Again, they may also refer you to work with a dietician. 
     
  • Alternatively, if you are not planning to become pregnant and/or have PCOS, they may ask you to go on The Pill. That won’t make you ovulate – it actually does the opposite if you are ovulating – but, importantly, it will produce a cyclical bleed that clears the womb lining monthly, keeping the womb healthy and allowing fresh, healthy blood cells to line the area, whilst eradicating the old ones.    
     

Did you know…? Many women still avoid The Pill due to fear of increased risk of breast cancer and blood clots BUT the studies relating to those findings are HUGELY OUTDATED. In actual fact THE PILL PROTECTS AGAINST ENDOMETRIAL CANCER AND OVARIAN CANCER, maintaining a regular shedding of the womb lining and keeping it healthy. The Daily Mail and other media don’t tell you that when they’re scaremongering!
 

Did you know… Studies show that 10’s of thousands of women’s lives have been saved in the past 30 years due to ‘at risk’ women being on The Pill, and not having gotten endometrial or ovarian cancer?


What happens if I don’t regulate my period?  
It’s not good for the body not to ovulate regularly as it can increase the thickness of the womb lining (i.e. resulting in a build up of old and new blood cells), which in turn can increase your risk of endometrial cancer, as well as affecting your future fertility. 


What happens if I have endometrial cancer?
The sooner the pre-cancerous changes are diagnosed and you receive treatment, the better. The earlier the treatment, the less invasive it will be - on your body, they type of treatment, and in affecting your lifestyle.

For example, the examination for gynecological cancers is a relatively quick and pain free procedure. Your doctor will perform a transvaginal ultrasound (TVU) or colposcopy to examine the cervix. Essentially, we magnify it with a pair of binoculars, paint it with vinegar and that identifies any abnormal areas. Then we take a small biopsy from those areas to investigate further. That will determine whether or not you have cancer. If you do and it’s at the pre-cancerous stage, we’ll conduct a small procedure under local anesthetic to remove the pre-cancer and your risk returns back to that of the general public. It’s very similar to what we do for cervical cancer. The later the diagnosis, the more invasive the treatment will be.

 

Concerned? Visit the Eve Appeal for more information or to seek advice on gynaecological cancers.




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