by Jackie Hart, MD
Q: My period is irregular and unpredictable and my doctor has suggested either the Pill or a hysterectomy. Are there any alternatives?
A: The first step in deciding what to do for irregular menses (often called dysfunctional uterine bleeding or DUB in medical jargon) is to determine if there is an existing, treatable cause. Common causes of DUB include stress, recent change in lifestyle, thyroid disorder, and other hormonal disorders including the production of too many male hormones called androgens, as is the case in women with Polycystic Ovarian Syndrome (PCOS).
Following an exploration for the cause and correction (when possible) of the underlying problem, the conventional approach to treatment frequently involves using the birth control pill to "regulate" the cycle, which essentially imposes a regular schedule of menstruation, thereby eliminating the irregularity and unpredictability. The Pill does this, though, by masking the cycle, not by creating a normal balance of hormones and menstrual flow.
I am assuming that you would like to try to resume a natural, regular menstrual cycle and keep away from side effects of medication (as well as risks of surgery from a hysterectomy). In terms of resuming a normal cycle, I have seen a great deal of clinical success with the use of acupuncture performed by licensed, certified acupuncturists. There are several small-scale studies confirming the objectivity of this success even in the case of PCOS.
Other measures to consider include eating a low-fat diet rich in fruits, vegetables, whole grains, and fish containing omega-3 fatty acids, which may reduce menstrual cramps and heavy bleeding. Weight-bearing exercise, such as walking, running, aerobics, and weight-lifting, is important because some women with irregular menses are at greater risk for osteoporosis. Finally, stress reduction through methods such as yoga, tai chi, meditation, or deep relaxation can be helpful if stress is contributing to DUB in any way.
There are times, though, when an ample course of the methods mentioned is not adequate, and oral contraceptives (the Pill) or some other medication or a surgical procedure must be considered. I want you to know this simply because you should not feel discouraged if the alternative methods do not fully restore your normal menstrual cycle. The approaches mentioned may help even if normal menstruation does not resume, as they can also be used to complement conventional medical care.
Q: My period is irregular and unpredictable and my doctor has suggested either the Pill or a hysterectomy. Are there any alternatives?
A: The first step in deciding what to do for irregular menses (often called dysfunctional uterine bleeding or DUB in medical jargon) is to determine if there is an existing, treatable cause. Common causes of DUB include stress, recent change in lifestyle, thyroid disorder, and other hormonal disorders including the production of too many male hormones called androgens, as is the case in women with Polycystic Ovarian Syndrome (PCOS).
Following an exploration for the cause and correction (when possible) of the underlying problem, the conventional approach to treatment frequently involves using the birth control pill to "regulate" the cycle, which essentially imposes a regular schedule of menstruation, thereby eliminating the irregularity and unpredictability. The Pill does this, though, by masking the cycle, not by creating a normal balance of hormones and menstrual flow.
I am assuming that you would like to try to resume a natural, regular menstrual cycle and keep away from side effects of medication (as well as risks of surgery from a hysterectomy). In terms of resuming a normal cycle, I have seen a great deal of clinical success with the use of acupuncture performed by licensed, certified acupuncturists. There are several small-scale studies confirming the objectivity of this success even in the case of PCOS.
Other measures to consider include eating a low-fat diet rich in fruits, vegetables, whole grains, and fish containing omega-3 fatty acids, which may reduce menstrual cramps and heavy bleeding. Weight-bearing exercise, such as walking, running, aerobics, and weight-lifting, is important because some women with irregular menses are at greater risk for osteoporosis. Finally, stress reduction through methods such as yoga, tai chi, meditation, or deep relaxation can be helpful if stress is contributing to DUB in any way.
There are times, though, when an ample course of the methods mentioned is not adequate, and oral contraceptives (the Pill) or some other medication or a surgical procedure must be considered. I want you to know this simply because you should not feel discouraged if the alternative methods do not fully restore your normal menstrual cycle. The approaches mentioned may help even if normal menstruation does not resume, as they can also be used to complement conventional medical care.