Irregular cycle, why?
February 23, 2015 1:03 AM   Subscribe

What are plausible explanations for a short cycle in this instance?

And what should I ask my doctor about? Asking to prevent Googlitis.

Late 30s, have "lots of little" ovarian cysts (quote from an ultrasound report three years ago), no BCP, no kids, currently inactive; 2 irregular paps (nominally watching this, but last checked over a year ago); a few large thyroid nodules, being watched. Cycle length has varied +/- 4 days for years (25-29 days). Painful periods, which I've always had, are usually managed more or less well with prescription pain medication.

Last period was 15 days ago, a few days earlier than my tracker predicted. It came with mind-bendingly excruciating, outrageous pain. The meds didn't work (though I didn't expect the cycle to come quite so early, so didn't take them in advance as I often do). Vomited twice from pain, was dizzy and in a cold sweat, could barely walk. The TeleHealth nurse recommended going to the ER (which I did, but it was full of seriously ill people, and understaffed, and the pain started to abate while I was in the waiting room (maybe the meds finally kicked in?), so I went home).

Just got another one now (proper period, not spotting). It's painful but it's my normal amount of pain.

Could the severe pain of my last period have been due to a ruptured cyst? If not, what else could it have been? If it might have been that, would that explain the shortened cycle after it? What would? Perimenopause? Something else?
posted by cotton dress sock to Health & Fitness (7 answers total) 5 users marked this as a favorite
Endometriosis? Not a MD but I did live with someone who has that and it took two years to figure it out. Utterly debilitating. Maybe the doctors are concentrating on the cysts too much to look for something else. I hope you feel better.
posted by Mr. Yuck at 2:46 AM on February 23, 2015 [1 favorite]

I've had a cyst rupture, and it was very similar to what you described regarding the pain (it felt like a really bad period, even a little emotional and general soreness everywhere, which is typical for my periods), but the blood was heavier and over with a lot sooner. My next cycle was a bit shorter, but I was also on a lower hormone BC where that happened somewhat regularly ( I tend to have shorter cycles anyways), so I'm not sure they're related.

I'm not sure what else could cause similar symptoms though, so a phone call to your physician might be in order to see if they have other ideas/concerns. Ask if they have suggestions for if it happens again or other symptoms to watch out for.
posted by ghost phoneme at 6:01 AM on February 23, 2015 [1 favorite]

I have a very similar profile to you, a bit younger than you. Ovarian cysts, no kids, thyroid nodules. But my cycles used to be much longer, skipping months or two, and they were always as painful as that, vomiting, etc. I've been to the ER for period pain. In the past few years my periods have regulated and they're now regular at 30-35 days apart.

I'm not sure where you are healthcare-wise or what your options are for gynecologist shopping, but it's taken me 20 years to find a gynecologist who actually paid attention. All previous gynecologists as soon as they heard "not trying to get pregnant" would just say "go on the Pill and we'll worry about it if/when you're trying and failing to conceive." I happen to just, you know, feel that it's important for my body to just work properly, and that the sole purpose of my reproductive/female/hormone systems is not just to conceive, but many doctors don't share that view, male, female, young, old, doesn't matter.

Not sure if you know this, but this was huge for me to discover a few years ago--the timing of your period is based off of when you ovulate (or whatever your body thinks is ovulation, which is why you can get your period on the Pill). Your period comes 14 days after ovulation. So it's the date of ovulation that fluctuates, not the period.

There's a lot of stuff having to do with female hormones and reproduction that they really just don't know, and/or it sometimes is not worth it to diagnose definitively, like endometriosis. Like there is a type of dysmenorrhea that just has no known cause and they're just fine with that. Maybe one day we will get some of the Viagara and male pattern baldness medical research funding.

So I guess my answer is, shop for doctors although even the best doctor might not be able to really tell you anything. Your other option is to try regulating your hormones. I've heard of success with the "insulin-resistance diet".

And for pain I actually recommend muscle relaxers, real ones, not psycho-muscle relaxers. I got prescribed cyclobenzaprine (Flexeril) for whiplash and it works beautifully for my cramps. And obviously tons of ibuprofen--I got an 800mg prescription from my gynecologist.

Good luck.
posted by thebazilist at 7:48 AM on February 23, 2015 [3 favorites]

"Lots of little ovarian cysts" is one of the diagnostic criteria for Polycystic Ovarian Syndrome. It's just one--you also have to fill other criteria as well, so this is not necessarily the right answer for you. PCOS is a surprisingly common but somehow unfamiliar-to-many-doctors condition, and it causes/involves irregular cycles. If you've ever had irregular hormone levels come back from blood tests, or if you have blood sugar/insulin resistance issues as well, then definitely talk to someone about it.

Regardless, this sounds like a situation to go see your gynaecologist or GP about. Irregular cycles and dysmenorrhea are legit medical issues that you should get checked out, and there are a pretty wide variety of potential causes that a doctor can help you look into.

(Obligatory: IANYD, just a person with PCOS.)
posted by snorkmaiden at 8:19 AM on February 23, 2015 [2 favorites]

Thanks, you guys, and I'm sorry, for those who have personal experience to contribute :(.

I don't meet a lot of PCOS criteria, but that's the assumption we've been going with so far. I'm not a good candidate for BCP, though, so it's just been down to pain medication. I've never missed a period, they're just slightly variable, usually. Actually looking at the tracker for the past year, most of them have been between 24 and 29 days, with a few 22 and 23 day ones in the mix, but steadily decreasing in length over the past six months (27, 24, 23, now 15, unless something weird happened with the last one).

I'm not feeling overly bad right now; I'm just wondering why this happened. Maybe it's nothing, after all?

I'll be trying the muscle relaxants, and will try to see my doc, of course.

Thanks so much, again.
posted by cotton dress sock at 9:49 AM on February 23, 2015

Chiming in to recommend asking about PCOS. I don't meet most of the criteria either, but lots of little cysts and irregular cycles are signs of atypical PCOS. Treatment for PCOS has worked wonders for me, both in managing symptoms and aiding in getting and staying pregnant.
posted by peanut_mcgillicuty at 10:57 AM on February 23, 2015 [1 favorite]

That sounds very similar to my experience of rupturing cysts. Once, my pain was so bad that they scheduled me for exploratory surgery and found the remnants of a lemon sized cyst that had burst. (Why is always fruit comparisons?) I also get small clusters of cysts, and I know some of them recently burst because I had two months of getting my period every two weeks.
posted by Ruki at 4:00 PM on February 23, 2015 [1 favorite]

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