What Is Irregular Menses?

Irregular menses is a big problem today in women. The normal length of a woman’s menstrual cycle is 28 days, but it varies for every individual. A period, or menstruation, is a part of the menstrual cycle in which the endometrium known as the lining of the uterus is shed. Thus bleeding from the womb happens which is then released from the vagina. 

Usually period’s starts at puberty, that is between the age of 10 to 16 years and it continues till menopause that is when a woman becomes 45 to 55 years old. Irregular menses problem can suggest an issue that needs to be addressed with your healthcare provider. It can happen due to several reasons such as hormone imbalance, menopause, and so on. 

There can also be medical conditions that affect your hormones or structural reproductive tract. Often these go undiagnosed and untreated.

What defines an irregular menstrual cycle?

An average menstrual cycle lasts for 28 days, although it is quite normal for it to be a bit longer or shorter than this. A cycle is considered irregular when most of the cycles in the last six months are out of range. People with irregular menstrual cycles may experience that their periods happen frequently, infrequently, or are very unpredictable. 

Irregular periods may include abnormal uterine bleeding like:

• Bleeding or spotting between periods 
• Heavy bleeding during periods
• Bleeding after intercourse
• Menstrual bleeding going on for longer
• Bleeding after menopause

So women with the above issues are to have irregular periods problem should consult the doctor.

Causes of Irregular menses

There are a several factors that increase the chances of irregular period problems. Most of them are related to hormones and some medical conditions. Two hormones having an impact on menstruation are estrogen and progesterone. Here are some of the conditions being the reason for irregular menses causes:

Puberty 

At the time of puberty, the body undergoes several changes. It may take several years for estrogen and progesterone to reach a balance, thus irregular periods are common at this time.

Perimenopause

Prior to menopause women often have irregular periods, and the amount of blood released from the body may vary. Usually, menopause starts when 12 months have passed since the woman had her last period. After menopause women don’t get their periods anymore. 

Pregnancy

During pregnancy, you can miss your period or experience spotting. Some of the symptoms of early pregnancy may include:

• Morning sickness
• Sensitivity to smell
• Nausea
• Breast tingling or tenderness
• Fatigue

If you have missed your period or notice changes in your period and you have had intercourse without protection then you can take a pregnancy test at home. Pregnancy also causes irregularity in menses.

Hormonal Birth Control

Contraceptives can cause irregular bleeding. Heavy bleeding can be caused by an intrauterine device (IUD), while contraceptive pills can cause spotting between periods.  

Breastfeeding

A hormone known as prolactin is responsible for breast milk production. Prolactin usually suppresses your reproductive hormones thus it results in a very light period or no period at all till you are breastfeeding. 

Polycystic ovary syndrome (PCOS)

The most common sign of PCOS is irregular periods. If you have PCOS you may miss periods and when you get your periods, heavy bleeding happens. PCOS can also cause:

Thyroid

In 2015 a study found that 44 percent of women with menstrual irregularities also had thyroid disorders. 

Hypothyroidism is also known as underactive thyroid can cause longer, heavier periods besides increased cramping. One may also experience fatigue, weight gain, and sensitivity to cold. 

A high level of thyroid hormone, which is present in hyperthyroidism, can cause shorter, lighter periods. One can also experience:

• Sudden weight gain
• Heart palpitation
• Anxiety and nervousness

Sometimes you may also experience swelling at the base of your neck which is also known to be a common sign of thyroid disorder.

Uterine fibroids

Uterine fibroids are known to be muscular tumors that develop in the wall of the uterus. Most fibroids are non-cancerous and their size can range from as small as an apple seed to the size of grapefruit. 

Due to fibroids, you can have very painful and heavy periods that may lead to anemia. You may also experience:

• Pain or pressure in the pelvic area
• Pain in your legs
• Low back pain
• Pain during intercourse

Treatment is not required for most fibroids and the symptoms can be managed with over-the-counter pain medications. And if you develop anemia iron supplements can be helpful.

Endometriosis

1 in 10 women of reproductive age is affected by endometriosis. In this condition, the tissue that usually lines the uterus grows outside the uterus.

People with endometriosis face very painful even sometimes debilitating menstrual cramps. Endometriosis sometimes also causes prolonged bleeding, heavy bleeding, and bleeding between periods. Some of the other symptoms are:

• Painful bowel movement
• Gastrointestinal pain
• Infertility
• Pain during and after intercourse

The only way to diagnose endometriosis is exploratory surgery. Currently, there is no cure for the condition but symptoms can be managed with medication or hormone therapy.

Being overweight

It is well known that obesity causes menstrual irregularity. As per research, it is said that being overweight can impact your hormones and insulin level thus an causing irregular menstrual cycle. 

Extreme weight loss and eating disorders

Rapid weight loss can stop your periods. Consumption of no calories can interfere with the production of the hormones that are needed for ovulation. If you have a body mass below 18.5 you are considered underweight. Besides stopping periods you may also experience headaches, fatigue, and hair loss.

Excessive exercise

It is said that intense or excessive exercise usually interferes with the hormones that are responsible for menstruation. 

Female athletes and women participating in intensive training and physical activities like ballet dance often face amenorrhea, which is missed or stopped periods. So decreasing your training and increasing your calorie intake can help restore your periods.

Stress

As per research, stress can interfere with your menstrual cycle by temporarily interfering with the part of the brain controlling the hormone that regulates your cycle. Once your stress lowers your periods usually return to normal. 

Some Medications

Some of the medications have an impact on your menstrual cycle:

• Blood thinner
• Epilepsy drugs
• Hormone replacement therapy
• Thyroid medication
• Antidepressants
• Aspirin and ibuprofen
• Chemotherapy drugs

If you are facing any issue with your menstrual cycle, then speak to your doctor about changing the medicine.

Cervical and endometrial Cancer

Cervical and endometrial cancer can cause changes in your menstrual cycle, along with heavy periods or bleeding between periods. Some of the other signs of these cancers are bleeding during or after intercourse and unusual discharge. 

So here is the answer to the question ‘What is the reason of irregular menses?’

What are the symptoms of irregular menstruation?

The length of the menstrual cycle and the amount of blood flow is unique for every woman. Well, most of the women have a cycle of 28 to 34 days. Blood flow continues for 4-5 days, along with a blood loss of 40 cc. These are just average calculations so your normal may fall outside these ranges. A blood loss of 80 cc or more is considered as abnormally heavy flow. 

Some of the symptoms that you are having abnormal menstrual cycle:

• Soaking more than one sanitary pad or tampon in an hour for many hours at a stretch.
• Waking up many times in the night due to heavy flow and you need to change your pad.
• Passing large blood clots during the menstrual cycle
• Menstrual flow lasting for more than a week

While every woman’s cycle is different, so irregularities like bleeding mid-cycle or bleeding after intercourse is known as irregular menstruation symptoms.

How irregular menstrual period is diagnosed?

If you are facing an abnormal menstrual period your doctor may initiate with a pelvic examination to understand the problem. Depending on your symptoms, some of the diagnostic tests may include:

Pap smear

This test checks for any infection or cancerous cells in the cervix.

Blood Tests

A blood test is performed to check for thyroid, anemia, and blood clotting problems. 

Pelvic ultrasound

Through pelvic ultrasound images of your uterus, pelvis and ovaries are seen.

Endometrial biopsy

If the doctor wants to evaluate the possible issues with your uterus they may recommend an endometrial biopsy. In this procedure, a sample of your uterine tissue is taken for analysis. 

Hysteroscopy

To view the inside of your uterus doctor may go for a hysteroscopy. For this procedure, he may use a lighted tube to view the uterus and remove the polyp. 

Sonohysterogram

A sonohysterogram is an ultrasound wherein a fluid is injected into the uterus to make an image of your uterine cavity. In this way your doctor will be able to look for polyp or fibroids.

Pregnancy Test

Your doctor may recommend a pregnancy test.

These are some of the ways to diagnose the cause of irregularity of the menstrual cycle.

What are the treatment options available for irregular menses?

The irregular menses treatment depends on:

• Your overall health
• The reason for your menstrual abnormalities
• Your reproductive history and future plans

The doctor may also need to address any underlying medical condition, like thyroid dysfunction.

Here are some of the menses irregular periods treatment options available:

Medication

Some of the medication treatments your doctor may suggest include:

• For reducing mild blood loss, nonsteroidal anti-inflammatory drugs (NSAIDS), like ibuprofen or naproxen are recommended.
• For treating anemia iron supplements are suggested
• To treat hormonal imbalance hormone replacement injections are recommended.
• Oral contraceptives are suggested to regulate your cycle and shorten periods

Medical procedures

D&C

D&C also known as Dilation and curettage is a procedure where your doctor dilates your cervix and scrapes tissue from the lining of your uterus. It is a quite common procedure and cuts down on menstrual bleeding.

Surgery

Surgery is the most common procedure opted for cancerous tumors. It is also known to be an option to treat fibroids, but not always necessary. Polyps could be removed by hysteroscopy.

Endometrial ablation

Endometrial ablation is a procedure that is used for women who didn’t benefit from medication to control heavy bleeding and related symptoms.in this procedure your doctor destroys the uterine lining, leaving little or no menstrual flow.

Endometrial resection

In this endometrial resection procedure, the uterine lining is removed. This procedure decreases your chances of future pregnancy. So, if you are planning to have children in the future then you need to discuss and consider other options.

Hysterectomy

Hysterectomy is a procedure where surgical removal of the uterus and cervix is done. If required your doctor may also remove your ovaries resulting in premature menopause.

For women who have cancer or fibroids, this procedure is considered as the preferred treatment. With this procedure, endometriosis can also be treated that has not responded to other less invasive treatment methods. Hysterectomy removes your ability to bear children.

Irregular periods treatment for married or unmarried women are the same and depend on the cause of the abnormality. Thus your doctor would first analyze the cause and would accordingly suggest treatment options.  

What are the complications associated with irregular menstrual cycles?

It is not necessary that heavy blood flow is a sign of abnormality. However, excessive loss of blood can lead to depletion in iron supply and cause anemia. If there is mild anemia it can cause fatigue and weakness. In more severe cases it may result in the following symptoms:

• Shortness of breath
• Dizziness
• Headaches
• Rapid heart rate

A very heavy flow can cause painful cramping or dysmenorrhea and it may sometimes need medication.

When to see your doctor?

Most people take irregularities of menses lightly. You should never take it lightly and should know what to do if menses are irregular? Visit your doctor if you have had regular periods and the pattern has changed now. The doctor may recommend physical examination and tests to rule out pregnancy or other health problems. You should visit your doctor if you have any of these problems:

• In a year if you miss three or more periods
• You get your periods less often than every 35 days
• You get your periods more often than every 21 days
• If you bleed for more than 7 days
• During your periods if you are bleeding more heavily than usual
• If you feel more cramps than usual during the period

If you are facing any such issues you should visit your doctor soon to rule out the problem.

Conclusion

The duration and severity of menstrual bleeding vary from woman to woman. Most women have a menstrual cycle that lasts four to seven days. A woman gets her period usually every 28 days. A normal menstrual cycle ranges from 21 days to 35 days. It is considered irregular menstruation when the length of a cycle is more than 35 days. 

There are several causes and symptoms of an irregular menstrual cycle. Some of them can be treated with medication whereas others need medical procedures. It is better to discuss with your doctor early if you face any of the symptoms so that they can be taken care of as soon as possible before it causes any major problem.  

FAQs

What is considered an irregular period?

Irregular periods are when the length of your menstrual cycle keeps changing. You may get your periods early or late. The average menstrual cycle lasts 28 days, although it is quite normal for a cycle to be a bit shorter or longer.

How do you known if you have regular or irregular periods?

Your menstrual cycle is counted from the first day of your last period to the first day of your next period. Your period is known to be irregular if it’s longer than 38 days or if the duration varies.

Is there any treatment for irregular periods?

Usually, doctors prescribe birth control pills (oral contraceptives) that consist of hormones estrogen and progesterone to help control irregular periods. For women who don’t get their periods a hormone medication known as progestin is prescribed to trigger periods.

Can I get pregnant with irregular periods?

Yes, irregular periods don’t usually affect fertility. In fact, many women with irregular menstrual cycles get pregnant and go on to have normal pregnancies.

Which is the best medicine for irregular periods?

Medroxyprogestrone is the name of tablets to regulate periods. 

References

https://www.medicalnewstoday.com/articles/178635#causes

https://my.clevelandclinic.org/health/diseases

https://www.nhs.uk/conditions

https://helloclue.com/articles/cycle-a-z

https://www.pennmedicine.org/updates/blogs/womens-health

https://www.webmd.com/women/why-is-my-period-so-random

https://www.medicalnewstoday.com/articles/322643#pregnancy