While some medical experts say your period “should have become regular and predictable”, your cycle during this decade can actually be more tumultuous: exciting, confusing and a little disorderly to be quite honest. While past the teenage awkwardness that naturally comes along with body changes, I think most women, in retrospect, would describe this menstrual stage as a time of discovery and experimentation. In your twenties, we learn what internal (hello, birth control) and external (stress!) environmental factors impact our cycle, and then try numerous, mostly-educated-guessed remedies from “Dr. Google”, am I right?
I have several “menstrual memories” from my twenties that I can finally reminisce about now with endearment. I remember several surprise appearances from my very irregular period and a few instances being curled up on my bathroom floor suffering from excruciating, mind-numbing cramps (there’s a reason for that!). Karen Boyle, M.D., sexual health specialist, says that because the hormone, prostaglandin, is at its highest level of production in your twenties, your cramps are significantly more intense (Mayo Clinic, 2018). Prostaglandins are a group of cyclic fatty acid compounds made at sites of tissue damage or infection, where they cause inflammation, pain and fever as part of the healing process — most notably the promotion of uterine contractions (Endocrine Society, 2018). That explains why our cramps can sometimes be so monstrously painful! I’ll share a tidbit I discovered during my twenties: sipping on sugar-free ginger ale stops my period cramps. I still use it today.
Your period evolves during every stage of womanhood. As we get older, our cycle continues to adjust based in part to normal age-related hormonal changes. In an exclusive interview with Redbook Magazine, Alyssa Dweck, M.D., Assistant Clinical Professor of Obstetrics and Gynecology at Mount Sinai School of Medicine, confirms “There's an unspoken rule among doctors that a woman's period tends to change through the decades." Dweck adds that "Your cycle is often an indicator of what's going on in your health and in your life, and there are many transitions between your 20s, 30s, and 40s."
Let’s find out more about what’s common about menstruation, what might be cause for concern and why it matters during your twenties.
The Cleveland Clinic describes menstruation as follows:
“The menstrual cycle is a term used to describe the sequence of events that occur within a woman’s body as it prepares for the possibility of pregnancy each month. A menstrual cycle is considered to begin on the first day of a period. The average cycle is 28 days long; however, a cycle can range in length from 21 days to about 35 days.”
If your cycle falls outside of the ‘normal’ cycle range, please note that 81% of women's cycles occur every 21 to 45 days and can last anywhere from a few days to a full week (Allina Health, 2016).
Potential Impacts of Birth Control. There's a chance switching contraceptives in your twenties could change your period cycle from how it was in your teens (or at any age, really). Depending on the type you're using, starting a new birth control method can lighten your flow or even make it non-existent (Medical News Today, 2018). The Pill or another form of hormonal contraception (like the hormonal IUD or the birth control shot) can even cause your periods to disappear. Birth control pills prevent ovulation, and without ovulation, there's no uterine lining buildup that has to be shed (Harvard University, 2008). Dr. Dweck insists that this is not something to overly worry about, especially since it typically takes a few months for your body to adjust. But if your period continues to be in flux for more than three months, Dr. Dweck recommends scheduling an appointment with your OBGYN visit right away just to confirm everything is fine.
Potential Impacts of Stress. As we all know, there are circumstances and situations that can trigger stress at every stage of life, but there are several particularly unprecedented, monumental moments that tend to happen specifically in our twenties. Interviewing for your first full-time job, losing that job, moving to a new city or state, getting in (and out of) a serious relationship: Dr. Dweck says all of these significant life events can have an affect on your period because stress hormones disrupt the signal from your brain to your ovaries. This can cause an erratic period for a few months. In fact, for some women, stress may play a role in causing irregular or missed periods (Natural Womanhood, 2018). As stress levels rise, it’s possible that your cycle will temporarily stop, a condition known as secondary amenorrhea. However, if it doesn't last very long then there likely isn't anything to be heavily concerned about.
Additional abnormalities you might experience during your reproductive years might include polyps, fibroids as well as anovulation (lack of ovulation), endometriosis (growth of endometrial tissue outside the uterus) and — less common — tumors/growths (Allina Health, 2016). Bleeding can also be a symptom of infection such as endometritis (infection of the inner lining of the uterus) or pelvic inflammatory disease (Allina Health, 2016). Remember, not all bleeding and irregularity is a cause for concern. For example, it is very common to have irregular bleeding with some contraception methods. Stress and other issues can also cause periodic changes to your cycle (Allina Health, 2016).
Your twenties can be tough and in more ways than one. A LOT is happening. If you're not stressed out more than usual — and you're for sure not pregnant — but you begin to notice an ongoing inconsistency in your cycle pattern (i.e., your period either goes MIA or lasts for more than a week), then there could be a possibility that you have Polycystic Ovarian Syndrome. PCOS is a hormonal imbalance disorder common among women of reproductive age (Mayo Clinic, 2018). While it has a tendency to show up in women in their twenties, you can actually be diagnosed at any time; signs and symptoms of PCOS often develop during puberty (Mayo Clinic, 2018).
Women are at their peak fertility potential in their twenties (American Society for Reproductive Medicine, 2012) and PCOS is a serious condition that could potentially affect your ability to get pregnant (PCOS Awareness Association, 2017). Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs (Mayo Clinic, 2018). Don’t panic! PCOS isn't the only likely reason behind your irregular cycles or vanishing period. Besides pregnancy, your period may stop entirely if you have experienced a major change in weight gain or weight loss in a short amount of time. Dr. Dweck notes that a thyroid disorder can also cause your periods to get much heavier. There are treatment options for each, so it's important to be completely honest with your doctor to determine the root of your particular problem. If you think you may be suffering from PCOS (other symptoms include unwanted/excess hair growth and acne), then go see your OBGYN as soon as possible. The exact cause of PCOS is unknown, but the good news is early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease (Mayo Clinic, 2018).
If you are currently in your twenties, are you experiencing any of these issues? If you’re like me and that decade is behind you, is there anything you wish you would have known then? We’re happy to help answer any #MenstruationMatters questions you have. Reach out to Kindara directly at firstname.lastname@example.org for additional information and resources. Keep up with Kindara on Facebook, Twitter and Instagram for new blog posts and look for more from our #MenstruationMatters series! Up next: Why Periods Are Important In Your 30s.