“And Just Like That,” the much anticipated follow-up to “Sex and the City,” depicts the beloved characters dealing with life in their early 50s. In episode nine, Charlotte breezily reported she hadn’t had a period in four months and was through menopause without any hot flashes. Later, she unexpectedly bled while wearing a white jumpsuit (we’ve all been there for that moment). Miranda, tying a sweater around Charlotte’s waist, informed her it was a “flash period.”
“A flash period is not a medical term,” said Dr. Mary Jane Minkin, clinical professor of obstetrics, gynecology and reproductive science at Yale Medical School and member of HealthyWomen’s Women’s Health Advisory Council. However, she added, “a period out of the blue from nowhere is a very common thing.”
Any woman, at any point in her life, can have a period with no warning, even women with very regular monthly cycles. “Funky ovulation due to Covid or stress is very common,” Minkin said.
Women experiencing perimenopause, the years before menopause when periods become irregular and symptoms like hot flashes, night sweats and insomnia abound, may think they’re done then suddenly have a period, then go months again with nothing.
Menopause, defined as the years after a woman has gone one full calendar year without a period, generally means no more bleeding. However, Minkin points out surprise periods are rare but possible even then.
Periods are created by a complex relationship between the pituitary gland, hypothalamus, ovaries, uterus and hormones that carry messages between them. Any disruption to that message chain can bring an unexpected period.
“Perimenopause is the Wild West for periods,” Minkin explained. “You could go months without one and suddenly bleed.” And you may not have any bloating, mood swings or cramping as warning signs because your body may not go through a full cycle.
“Always carry pads and tampons with you until you’ve gone a full year without a period,” she advised. “And while pregnancy is not common then, it can still happen.”
If you are perimenopausal and get a sudden period, Minkin said it’s useful to call your healthcare provider (HCP) and let them know so they can track your periods in your chart. Irregular periods at this stage are common and usually not concerning, although she warned, “I’m more concerned with a little staining here and there which could be a polyp than with a big bleed, which is just screwy hormones.”
If you go more than a year without a period and then get one, call your HCP because it is considered abnormal, and some investigation is needed.
There is a way to prevent flash periods. Your HCP can help you manage irregular bleeding and control your perimenopausal symptoms while also preventing pregnancy with the birth control pill.
Any woman can have a sudden, unexpected “flash period,” but it’s always a good idea to keep your HCP in the loop. And don’t wear a white jumpsuit unless you’re really confident you’re in the clear.