Normally, the menstrual cycle is composed of 28 days, where menstruation (bleeding) occurs for approximately 3-7 days for a regular person. It begins at the age of 10-16 years, which is known as menarche and ends between ages 45-55, known as menopause.
During the menstrual phase, the uterine lining (endometrium) sheds in the form of blood, mucous and clots, before regenerating. This process of endometrial shedding every month is known as “menses.” The length of the menstrual cycle can vary in women, from 21 to 35 days, depending on person to person.
Irregular periods refer to the state of abnormal cycle lengths, which could be less than 21 days or more than 35 days. It could also be due to abnormalities in the volume, frequency, and duration of periods. There are certain terms which can be used to describe irregularities:
Oligomenorrhea: Infrequent periods, usually occurring after more than 35 days.
Menorrhagia: Heavy menstrual bleeding, which accounts for excessive loss of blood.
Amenorrhea: Lack of menstrual bleeding.
Dysmenorrhea: Extremely painful bleeding, especially the first 2 days
Polymenorrhagia: Heavy and more frequent bleeding, especially earlier than 21 days.
Hypomenorrhea: Short or extremely light periods
Causes of irregular periods:
There are various causes of irregular periods but mostly, they are related to hormonal imbalances as menstruation is highly dependent on hormones such as LH, FSH and estrogen, progesterone, which regulate the cycles. These causes include:
Pregnancy: The state of pregnancy is retainable when the fertilized egg embeds itself into the endometrial lining. Hence, the menstrual cycle pauses in order to prevent endometrial shedding, so the embryo can grow in it. Pregnancy may be confused for irregular periods, especially if there may be spotting noted.
Lactation: Lactational amenorrhea is a normal physiological process, where a hormone called Prolactin is released during breastfeeding, which causes very light or scanty periods till the mother breastfeeds.
Birth Control Pills: Hormonal birth control pills or certain medications can alter hormonal levels, leading to irregular menstruation. OCPS can cause spotting in between periods.
Stress: Stress is a major factor in causing a delay in menstruation. The more the stress, the more irregular the pattern of periods becomes.
Polycystic Ovarian Syndrome: PCOS refer to the hormonal imbalance due to an excess of male hormone production in the female body. This causes multiple cysts to form on both the ovaries, along with other symptoms. One of the most common presenting features is irregular or heavy menstrual bleeding.
Thyroid Disorder: An overactive or underactive thyroid gland can lead to changes in the menstrual cycle, leading to irregularities.
Intra-Uterine Device: An IUD also releases hormones to prevent pregnancies and this regulation of hormones may cause irregular periods.
Obesity: Obesity has a direct link with PCOS, eventually leading to irregular menses.
Treatment and Management:
Getting the appropriate management is important when it comes to irregular menstrual cycles. The amount of menstrual problems is on the rise, especially in young girls these days. A healthy, balanced diet, along with an active lifestyle are recommended by every physician.
Besides this, if you or anyone you know faces the problem of irregular menstruation quite frequently, make sure to visit a gynecologist. After a full workup, any underlying disease or condition will be managed and treated accordingly. OCPs can be given for patients with PCOS while thyroid disorders can easily be managed using medication as well.
Irregular menstruation is easily treatable nowadays with the advancement of modern medicine. Women of child bearing age with multiple medical issues can smoothly conceive after receiving the right treatment. If you face any irregularities in your menstrual cycle, consult a doctor as soon as possible, as there are quite many complications of leaving underlying medical conditions untreated.