Irregular menstrual cycle

An irregular period is a menstrual cycle which for an unexpected reason, continually falls outside "regular" ranges. 

Some variability is normal in your cycle length. Irregularity is also typical and expected when your periods first begin in life (menarche), and when they are coming to an end (perimenopause). They are also expected after pregnancy and while stopping or starting a method of hormonal birth control. 

In between these times, irregular periods can indicate an issue that requires to be addressed with your healthcare specialist. Irregular cycles could be caused by lifestyle, behaviors, and environment. They may also be caused due to medical conditions that influence your hormones or structural reproductive tract. These conditions usually go undetected and untreated. 

Cycles that are continuously irregular can have a serious impact on short- and long-term health.

The standard length of the menstrual cycle of a woman is 28 days, but between individuals, this varies. When the duration of the cycle is more than 35 days, or if the period varies, irregular menstruation occurs. 

The portion of the menstrual cycle in which the endometrium is shed, which is the lining of the uterus, is a phase of menstruation. This manifests as bleeding that is expelled into the vagina from the womb. 

Periods typically start between 10 and 16 years of age during puberty and continue until menopause, when a woman is 45 to 55 years old. 

A change in the method of contraceptives can also result in hormone imbalance, hormonal changes around the time of menopause and endurance workouts, and irregular cycles, often called oligomenorrhea. 

Treatment for irregular periods during puberty and during menopause is not usually required, although medical advice may be needed if irregular periods occur during the reproductive years.

If you're worried about the regularity of your menstrual cycle, keeping a written record of your cycles is a simple first move (or log them in your phone calendar). If it turns out that you're more normal than you realized, this record will help put your mind at ease. You will also be able to understand when constructive steps are to be taken. If you encounter an irregularity for many periods, make an appointment with your gynecologist (and if you don't have a gynecologist, find an AMITA Health OB-GYN near you).

Irregular menstrual cycle

What To Do When Having Irregular Periods?

Your body releases unfertilized eggs during your menstrual cycle each month. Your levels of estrogen and progesterone increase and thicken the lining of your uterus as they become fertilized to protect the eggs. If none of the eggs are fertilized, the excess lining is shed by your body in the form of your monthly cycle.

Usually, every 24 to 31 days, a woman has her period, lasting between four and seven days and losing between four to 12 tablespoons of blood. But not all women have cycles that are common.

Some women skip or have erratic cycles entirely. You may have more or fewer cycles, or you may lose more or less blood, or your periods may be shorter or longer. These situations may be triggered by ongoing medical problems or by changing medical or emotional conditions. The disorder causing intermittent intervals can be fixed or treated in most cases.

 

What Are Regular Periods? 

Between the ages of 10 and 15 years, most girls get their first period, but some get it earlier and some later. The first period is referred to as menarche (pronounced: MEN-ar-kee). 

A girl's menstrual cycle is the number of days from the start of her period to the start of the subsequent time she gets her period. You usually hear this is a 28-day cycle. But 28 is only an average figure that most doctors use. Cycle lengths usually vary — some are 24 days, some are 34 days. And a girl may observe that her cycles are of different lengths each month — specifically for some years after she first starts getting her menses. 

Early in a girl's menstrual cycle, her ovaries start producing one egg. Concurrently, the lining of the uterus becomes thick to produce a nesting place for a fertilized egg in the case that the girl becomes pregnant.

The egg is released from the ovary about two weeks before a girl gets her period (this is termed as "ovulation"). The egg moves into the uterus through the fallopian tube. If sperm does not fertilize the egg, it begins to fall apart. Then the lining and egg leave the body of a girl, and the whole thing begins all over again, which is why we use the word "cycle." Day 1 of her cycle is the first day a girl's period comes. 

A girl's body might not follow an exact schedule. It's common, especially in the first two years after a girl starts getting her period, to skip periods or to have irregular periods. Ailments, rapid weight change, or stress, etc., can also make things unpredictable. That's because the section of the brain that governs periods is influenced by events like these. Going on a trip or having a significant change in schedule can also make your period come at a different time than expected. All of this is perfectly normal.

It's also natural to vary the number of days that a girl has her period. Often a girl can bleed for two days, and sometimes a week can last. That's due to the level of hormones the body makes can differ from one cycle to the next, and this affects the length and amount of bleeding.

 

Symptoms Of Irregular Periods

A menstrual cycle lasts about 28 days; however, depending on the person, it can vary from 24 days to 35 days. 

Per year, most females have between 11 and 13 menstrual cycles. Bleeding normally takes about five days, but it can range from 2 to 7 days, too. 

It may take about two years to develop a normal cycle when menstruation first begins. After puberty, most women’s menstruation is regular. The period of time between each period is similar. 

However, for certain women, the time between periods and the amount of bloodshed vary considerably. This is called irregular menstruation. 

The primary symptom of irregular periods is when the cycle persists more than 35 days or if it differs in length. 

If there are alterations in blood flow, or if clots appear that are more than 2.5 cm in diameter, this is also considered irregular.

 

Irregular Periods Causes

The risk of premature menstruation is increased by a variety of factors. Some are related to the development of hormones. Estrogen and progesterone are the two hormones that affect menstruation. These are the cycle-regulating hormones. 

Hormonal Causes

Life cycle changes that affect the hormonal balance include - puberty, menopause, pregnancy, and childbirth, and breastfeeding. 

During puberty, the body encounters major changes. It may take several years for the estrogen and progesterone to reach a balance, and irregular periods are common at this time. 

Before menopause, women usually have irregular periods, and the amount of bloodshed may vary. Menopause takes place when 12 months have passed since the woman’s last menstrual period. After menopause, a woman will no longer have periods.

Menstruation ends during pregnancy, and most women do not have cycles when they are breast-feeding. 

Irregular bleeding can be caused by contraception. Heavy bleeding can be caused by an intrauterine device (IUD), while the contraceptive pill can cause spotting during periods. 

She will experience minor bleeds that are normally shorter and lighter than regular cycles when a woman first uses the contraceptive pill. These usually vanish after a couple of months.

Other likely changes that are associated with irregular periods include:

Extreme Weight Gain

  • extreme weight loss
  • emotional stress
  • eating disorders, including anorexia or bulimia
  • endurance exercise, for example, marathon running.

 

Also Read: Some Underlying Disorder Can Cause Menstrual Irregularity

 

Complications

Sometimes, irregular intervals can signify a health problem, and some of these can lead to more complications, such as fertility problems. 

 

  • Polycystic ovarian syndrome (or PCOS) is a condition in which the ovaries produce a number of small, fluid-filled sacs called cysts. There is no ovulation for a woman having PCOS, and she doesn't release an egg every month. Irregular or no cycles, obesity, acne, and premature hair growth are signs. The male sex hormone, androgen, or testosterone levels are exceptionally high for women with PCOS. Research says that PCOS affects between 10 - 20% of women of childbearing age or about 5 million American women. PCOS can occur in girls as young as 11 years old.
  • Irregular intervals may be caused by a thyroid disorder. The thyroid gland generates hormones that regulate the metabolism of the body. 
  • In extreme cases, cervical or uterine cancer, or womb cancer, can cause bleeding between periods or during the sexual drive. 
  • Endometriosis is a medical condition in which cells that are usually located within the uterus, called endometrial cells, expand outside it. In other words, the lining of the inside of the uterus is found outside of it. Endometrial cells are the cells that shed every month during menstruation, so endometriosis can impact women during their childbearing years. The cellular growth in endometriosis is usually not cancerous. There might be no symptoms, although it can be painful, and it can lead to other problems. If released blood gets stuck in the adjacent tissue, it can damage the tissue, causing severe pain, irregular periods, and infertility.
  • A female reproductive system infection is called a pelvic inflammatory disease. Among females, apart from AIDS, it is the most common and serious complication of sexually transmitted infections. 

It could be treated with antibiotics if it is detected early, but if it spreads, it may affect the fallopian tubes and the uterus, leading to chronic pain. There are various signs, including bleeding after sex and between cycles.

 

Talking To A Healthcare Advisor

Show them your history of the cycle when talking to your health care provider. Also, tell them if you have noticed unexpected changes in your body recently, such as unexplained abdominal pain, weight control difficulties, or unusual growth of hair on your face or body. This can help them detect what might be causing your cycle irregularity. 

A healthcare specialist will possibly ask questions about your symptoms and your medical and menstrual records and perform a simple physical exam. In certain cases, they may also: 

  • Ask questions regarding your full health history, including medical and surgical history, family history, and social history. 
  • Perform blood tests to monitor the levels of hormones and sugars in the blood. They will typically check for hormone levels, including thyroid hormone, testosterone, prolactin, and tests of sugar metabolism. 
  • Perform a pelvic ultrasound (sonogram) of your ovaries and uterus.

 

Treatment 

Treatment, if necessary, will depend on the cause. 

  • Puberty and menopause: Treatment is generally not necessary for irregular periods that occur during puberty or as a woman approaches menopause. 
  • Birth control: If irregular bleeding is happening due to contraception, and it continues for several months, the woman should talk to a healthcare professional about other options. 
  • PCOS and obesity: In some cases of PCOS, overweight, or obesity, losing weight can help stabilize menstruation. Lower weight means the body does not require to produce so much insulin. This causes reduced testosterone levels and better odds of ovulating. 
  • Thyroid problems: Treatment for the underlying condition is likely to be prescribed. This can include medication, radioactive iodine therapy, or surgery. 
  • Stress and eating disorders: Psychological therapy can help if emotional stress or unintended weight loss have caused your irregular periods. The therapy may include relaxation techniques, stress management, and talking to a therapist. 

 

Medications

Metformin, an insulin-lowering oral medication for type 2 diabetes, may be prescribed by a doctor to help ensure ovulation and regular periods. 

A low-dose birth control pill that comprises a mixture of progesterone and estrogen may help. This will minimize the production of androgen and will help to fix abnormal bleeding. 

Alternatively, it is most likely that periods will be regulated by taking progesterone for 10 to 14 days each month.




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