Health Facts

Irregular Menstrual Cycle

Every woman’s body is unique, and so is her menstrual cycle(periods). When you have a normal, moderately pain-free period each month, it’s a good indication that your reproductive system is working properly. But the reverse is also true when your cycles last longer and shorter than the normal range of 21-35 days or when you lose more or less blood than usual.

Having an unpredictable, irregular period is not uncommon in women. As per the American Academy of Family Physicians (AAFP), about 9 to 14 percent of women experience irregular periods in the first few years following puberty and right before menopause. While these menstrual irregularities aren’t always serious, keep an eye out for what’s normal and healthy for you to track the early signs of trouble. Discuss with your doctor about what to expect if you notice your periods are irregular and ask about the treatment options available to you.

Symptoms of Irregular Menstrual Cycle

Along with the change in the period length, you should be aware of these symptoms that may indicate an underlying reproductive health problem.

Spotting between periods

Light or no bleeding

Severe cramps in the belly

Breast tenderness

Bleeding after sexual intercourse

Heavy bleeding with blood clots

Discomfort in the bladder or rectum

Regular menstrual headaches

High fever

Foul vaginal discharge

Eating disorder

Change in mood

Causes of Irregular Menstrual Cycle

Irregular menstruation can have many possible causes, including:

  • Pregnancy or breast feeding or miscarriage
  • Changing birth control pills
  • Side effects of an intrauterine device(IUD)
  • Extreme emotional stress
  • Poor diet
  • Age
  • Smoking and alcohol abuse
  • Extreme weight loss or over-exercising
  • Overactive thyroid
  • Polycystic Ovarian Syndrome (PCOS)
  • Premature ovarian insufficiency/failure (POI/POF)
  • Uterine fibroids or polyps
  • Pelvic inflammatory disease (PID)
  • Premenstrual Syndrome (PMS)
  • Tumors or infections in the pelvic cavity
  • Bleeding disorders
  • Medications (blood thinners, antidepressants, chemotherapy drugs, steroids etc.)
  • Exposure to

Diagnosis and Treatment

To determine why you’re having irregular periods, your doctor will ask about your menstrual cycle, take a complete medical history, and perform a physical examination (including a pelvic exam). Depending on the findings, they may even ask you to have some blood tests, ultrasounds, and possibly a biopsy to be sure of the diagnosis. In rare cases, chromosome analysis may be suggested for women with a suspected chromosomal abnormality. 

The goal of the treatment is to correct the underlying condition. For this, some lifestyle changes may help, but medications or other procedures may still be necessary to address the issue. For example, your doctor may recommend oral contraceptives, hormone replacement injections, or iron tablets as drug treatments to trigger or correct your cycles. Other procedures that may be suggested are:

  • Fibroid removal surgery
  • Hysterectomy (for complete removal of the uterus) 
  • D&C (Dilation and Curettage) 
  • Endometrial resection
  • Endometrial ablation

FAQ's :

Some menstrual disorders are inherited. Which means you’ve acquired it from your parents and are born with it. For example, if your mother or sister has been diagnosed with polycystic ovarian syndrome or endometriosis, you are more likely to have these conditions causing your irregular periods.

Researchers have found that genetic makeup of a women has a very strong influence on the timing of the first period. This is especially true if the woman has primary amenorrhea, a condition that is present at birth and may not be noticed until puberty. Such women are more likely to have reproductive organ defects or certain genetic disorders such as Turner's syndrome, Kallmann syndrome, and congenital adrenal hyperplasia that causes absentia of menstrual period.

Premature or early menopause (medical term- premature ovarian failure) occurs when a woman stops producing eggs at a relatively younger age – usually before the age of 40. The causes are mostly genetic and have been linked to variations in several genes, including the estrogen receptor 1 gene (ESR1), estrogen receptor 2 gene (ESR2), cytochrome P450 1B1 gene (CYP1B1), BR serine/threonine kinase 1 gene (BRSK1), hexokinase 3 gene (HK3), and transmembrane protein 150B gene (TMEM150B).

Because irregular periods can occur due to underlying medical conditions with genetic components, genetic testing can be used to diagnose these conditions.   For instance, polycystic ovarian syndrome (PCOS) is one of the most common causes of the menstrual disorder, with a strong genetic association and having genetic tests widely available. Apart from that, karyotyping is typically used to diagnose genetic birth disorders such as Turner's syndrome, which frequently causes primary amenorrhea.

References:

  1. What’s Causing My Irregular Periods? | What You Need To Know. Retrieved May 12, 2022, from https://www.midatlanticwomenscare.com/blog/whats-causing-my-irregular-periods/
  2. Why Is My Period So Random? Why Irregular Periods Happen. WebMD. Retrieved May 12, 2022, from https://www.webmd.com/women/why-is-my-period-so-random
  3. Menstrual cycle: What’s normal, what’s not. Mayo Clinic. Retrieved May 12, 2022, from https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menstrual-cycle/art-20047186
  4. Irregular Periods: Why Is My Period Late? – Penn Medicine. Retrieved May 12, 2022, from https://www.pennmedicine.org/updates/blogs/womens-health/2020/november/irregular-periods-why-is-my-period-late
  5. How to Know If You Have Irregular Periods. Verywell Family. Retrieved May 12, 2022, from https://www.verywellfamily.com/what-is-an-irregular-period-1959924
  6. Bae, J., Park, S., & Kwon, J.-W. (2018). Factors associated with menstrual cycle irregularity and menopause. BMC Women’s Health, 18(1), 36. https://doi.org/10.1186/s12905-018-0528-x
  7. Abnormal Menstruation (Periods): Types, Causes & Treatment. (n.d.). Cleveland Clinic. Retrieved May 12, 2022, from https://my.clevelandclinic.org/health/diseases/14633-abnormal-menstruation-periods
  8. Thasneem, K., Kalarani, I. B., Jayaprasad, P., Mohammed, V., & Veerabathiran, R. (2022). Genes linked with early menopause and the pathogenesis of its associated diseases: A systematic review. Middle East Fertility Society Journal, 27(1), 1–11. https://doi.org/10.1186/s43043-021-00093-0
  9. Jahanfar, S., Lye, M.-S., & Krishnarajah, I. S. (2013). Genetic and environmental effects on age at menarche, and its relationship with reproductive health in twins. Indian Journal of Human Genetics, 19(2), 245–250. https://doi.org/10.4103/0971-6866.116127

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