I am a 41-year-old African American woman. I am also 50 pounds overweight and smoke about two cigarettes per day. Since I turned 38, I have skipped menstrual periods every year for the summer months of June, July and August. I had a tubal ligation in my early 30s, but I took a pregnancy test just in case, and that was negative. Am I a perimenopausal or menopausal candidate? What else could explain my lack of periods in the summer?

J.M.

Your lack of periods in the summer could be part of the entire perimenopausal picture, where irregular ovulation can lead to irregular periods. It also could be due to stress you suffer only in the summer -- visits from family, maybe, or changes in work with a more seasonal job. Changes in your weight during the summer may also be the reason you only skip periods then.

You should mention this to your gynecologist. Besides a discussing with you the health consequences of being overweight and ways to lose weight, your doctor can evaluate you for other conditions, such as an underactive thyroid, which may be causing you to miss periods.