My cycle is very irregular. My first period was at age 17, and it has always been a little off, but since I had my one child almost three years ago, I have only had 17 periods total. My last period was three months ago. I am 30, and I wish to have another child. My OB wants to put me on birth control, but I think that defeats my goal. Blood work and an ultrasound has found nothing. I have night sweats and often sweat doing the most minor of chores, such as washing dishes. Is it possible I am going through menopause? I don't want to go on birth control to regulate my period.

Carrie

I agree that it does not make much sense to take birth control pills if you wish to get pregnant again. If not, the birth control pill would be a very reasonable option to maintain regular cycles once you have completed a diagnostic evaluation to investigate causes for your irregular periods. The symptoms you describe could be related to an undiagnosed hormonal imbalance such as a thyroid abnormality, an underactive hypothalamus or pituitary gland, or premature ovarian failure.

A few simple blood tests and a transvaginal ultrasound may help clarify the cause of your menstrual disturbance and suggest options for treatment that would address the underlying problem, rather than simply masking symptoms with the birth control pills. If an FSH blood test is normal, that would rule out premature ovarian failure (early menopause) as the problem. A test of your TSH level would indicate whether you have an overactive or underactive thyroid gland. If you have signs of excess hair growth and weight gain, an androgen blood test and fasting insulin level may reveal polycystic ovary syndrome. The transvaginal ultrasound exam enables your physician to determine whether your ovaries are making follicles and the uterine lining is developing.

Stress, weight changes, exercise and dietary problems may also result in hormonal imbalances and irregular cycles. If no specific cause is noted, then birth control pills would be a reasonable option to prevent the higher risk of endometrial cancer often associated with infrequent menstruation.