Irregular Menses: Symptoms, Causes and Treatments

A menstrual cycle is normal vaginal bleeding that happens as a part of a woman's monthly cycle. Every woman is different, and every woman's period cycle is different, for some, it is like clockwork, and for some, it may come early or late.

• The length of the cycle can range from 21 days to 35 days
• The average duration of the cycle is 28 days
• A menstrual period usually lasts for 4 to 7 days

However, there may be some women for whom the length of the cycle may exceed 35 days. This means the menstruation cycle is not regular, and a woman has irregular menses. So, an irregular period is any cycle that would drift away from its monthly cycle, that means the length of the menstrual cycle would keep changing.

What Are The Possible Irregular Period Symptoms?

The symptoms of irregular menses, also called Oligomenorrhea, are:

• When the length of menses is less than 21 days or more than 35 days.
• If blood flow changes, such as when bleeding is too heavy or light or if a long clot appears, then it is considered irregular.
• If periods last more than seven days.
• Severe cramping, discomfort, nausea and vomiting during the time of periods.
• Three or more missed periods.

What Are the Possible Causes of Irregular Menses ?

Many factors can increase the chances of irregular menstruation, and the most common being a hormonal imbalance. The two hormones that regulate the menstrual cycle are oestrogen and progesterone, and their imbalance can disrupt the menstrual cycle. Other possible causes of irregular menses or irregular periods reasons are:

1. Stress or Anxiety

Getting stressed out on any problem, be it big or small can upset your hormonal imbalance, causing a missed period or an irregular cycle.

2. Poor Diet

A poor diet low in nutrients, antioxidants, and probiotic foods can strain the adrenal and thyroid glands, raising the level of cortisol in your body (a hormone released during stress). This resulting cortisol imbalance leads to changes in oestrogen and progesterone, thus disrupting the menstrual cycle.

3. Eating Disorders

Eating disorders like Anorexia and Bulimia have been linked with low levels of reproductive hormones, which causes irregular menses.

4. Extreme Weight Loss or Gain

Sudden weight gain or weight loss affects the regularity of menses as it affects the functioning of hormones.

5. Too much Exercise/Running/Cycling

The menstrual cycle is dependent on body fat and hormonal balance. Exercising too much can result in weight loss, shifting hormonal balance.

6. Using Birth Control Pills or Having an Intrauterine Device

Birth control pills or IUD's can make periods lighter, cause missed periods, or less or more frequent periods and even no periods at all.

7. Some Medications/Anticoagulants

Some antipsychotic antidepressants can cause irregular periods, and anticoagulants (blood thinners) like heparin and warfarin can make periods heavier.

8. Bleeding Disorders

If a woman has bleeding disorders like platelet disorders clotting factor deficiency, then it can cause prolonged or heavy bleeding.

9. Hyperthyroidism or Hypothyroidism

A thyroid disorder can cause irregular periods. The body's metabolism is affected by the hormone produced by the thyroid gland.

10. Hyperprolactinemia

In hyperprolactinemia (increased prolactin level), menstrual disorders like irregular bleeding, insufficient luteal phase, anovulatory cycle and amenorrhoea are common.

11. Pelvic Inflammatory Disease

A woman who has pelvic inflammatory disease might experience irregular menstrual periods, prolonged periods and spotting or cramps throughout the month.

12. Polycystic Ovary Syndrome

A woman with PCOS does not ovulate, so an egg is not released every month. So, the chances of irregular periods or no periods increase.

13. Uterine Fibroids

A woman with uterine fibroids if symptomatic can experience heavy bleeding, irregular bleeding or painful periods.

14. Endometriosis

If a woman has endometriosis, she will most probably suffer from irregular periods because the lining of the endometrium is shed every month during menstruation. But in this case, the lining is found outside the uterus.

Cancerous Growth Within the Uterus, Cervix and Ovaries can cause bleeding in between periods or during sexual intercourse.

Irregular Periods And Trying To Get Pregnant

Irregular periods (oligomenorrhoea), missed periods (amenorrhoea) or abnormal bleeding might indicate that there is a problem with ovulation. And in the absence of ovulation, it would be difficult to get pregnant with an irregular menstrual cycle.

However, in such cases, hormonal medication or fertility treatments may be recommended if a woman is not able to get pregnant naturally.

Does Irregular Periods Mean Infertility?

Having irregular menstruation or missed periods can be a major contributing factor to infertility. Irregular or abnormal ovulation accounts for 30 40 % of all cases of female infertility. If a woman is having irregular periods, no periods or unusual bleeding, then it is an indication that she is not ovulating (anovulation).

This leads to untimely egg release by the ovary and does not allow timely fertilisation of egg and sperm or at times no fertilisation at all, leading to infertility. Such cases require proper consultation and guidance from fertility experts.

What Are The Irregular Menses Treatment Options?

It is advisable to consult a doctor if you notice any symptoms of irregular periods. The treatment of irregular menses or irregular periods would be based on the cause of the symptom.

1. Medications

If the reason for irregular periods is due to hormonal imbalance, then the doctor may prescribe drugs or hormonal therapy to regulate the menstrual cycle.

2. Stress

If irregular menses are caused by stress, it is advisable to remain stress-free. This will help regulate the hormones, which in turn will control the menstrual cycle.

3. Underlying Diseases

If irregular menses are due to any disease or underlying bleeding disorders, then the doctor will first treat the primary disease, and then see its impact on the menstrual cycle.

4. Surgery

If irregular periods are caused by fallopian tube blockage or some structural problem in the uterus like uterine fibroids, then they can be removed through surgery to regulate the menstrual cycle.

5. Lifestyle Changes

A woman should attain a healthy weight, maintain a healthy lifestyle, quit smoking and restrict excessive alcohol consumption, eat healthy food and exercise, which can be beneficial in regulating the menstrual cycle.

Conclusion

Every woman is different in one way or another, including her periods. On average every woman gets her periods every 24 to 38 days. Even if your periods are irregular, it isn't always a sign of a problem, but sometimes it's a good idea to see a doctor.

Frequently Asked Questions