Missed or irregular periods can mean a lot. Bleeding may have started earlier or later than usual, you may have abnormally light bleeding or a heavier than usual flow, or it may mean that you do not have a period or two periods in one month.
A period is the flow of blood through the lining of the uterus during the menstrual cycle. Blood from a woman’s vagina ruptures through the vagina. Menstruation usually begins during puberty, between the ages of 10 and 16, and continues until menopause, between 45 and 55. Irregular periods are not an acute problem but sometimes can indicate other health problems. For this reason, if you have an irregular period, see a gynecologist.
What is a normal menstrual cycle?
The first day of menstruation is considered the first day of the menstrual cycle; this cycle continues until the next menstruation. The duration of the menstrual cycle varies from person to person. Monthly bleeding occurs every 21 to 32 days and lasts 2 to 7 days. The menstrual cycle will be longer in the early years when women experience menstruation. The older a person gets, menstrual cycles will be shorter and more regular.
During this period, the amount of bleeding should not be less than 30 ml or more than 80 ml. The color of the blood should not be too dark or too light.
A person’s menstrual cycle can be regular and last a certain amount each month. It can also be irregular or experience light, heavy, short, long, or even painful or painless monthly bleeding. All of these can be a normal menstrual cycle. This definition is specific and unique definition for each person.
As a woman approaches menopause, she will experience irregular period cycles. The risk of uterine cancer in women increases with age. Therefore, during menopause, if you notice any abnormal bleeding, consult your doctor.
Types of menstrual disorders
Types of menstrual disorders include:
- Abnormal uterine bleeding (AUB)
- Dysmenorrhea (painful periods)
- Premenstrual syndrome (PMS)
- Premenstrual dysphoric disorder (PMDD)
Possible causes for irregular periods
Your menstrual cycle is calculated from the first day of your last period to the start of your next period. Your period is considered irregular if it is more than 38 days or has a variable duration. Irregular periods can have a variety of causes, from hormonal imbalances to other underlying conditions.
Hormonal birth control
Intrauterine devices containing hormones and birth control pills can cause irregular bleeding. Birth control pills may cause spotting between periods, and using an IUD may cause heavy bleeding.
Prolactin is the hormone responsible for breast milk production. Prolactin suppresses reproductive hormones and leads to light periods or cessation of menstruation during lactation. Menstruation returns shortly after the end of lactation.
Perimenopause is the period that usually begins at age 40 but may occur earlier. Signs and symptoms may appear 4 to 8 years before menopause; it often begins with changes in the menstrual cycle. Fluctuations in estrogen levels during this period cause menstrual periods to lengthen or shorten. Changes in menstruation are usually accompanied by other symptoms such as hot flashes, night sweats, and vaginal dryness.
Polycystic ovary syndrome (PCOS)
Irregular periods are the most common sign of PCOS. If you have PCOS, you may miss your period or bleed heavily.
Uterine fibroids are muscle tumors that form in the wall of the uterus. Most fibroids are not cancerous and range in size from a small apple to a grapefruit. Fibroids can make your periods very painful and heavy, resulting in anemia in the long run.
Hypothyroidism can cause longer, heavier periods and increased cramps. You may also experience fatigue, cold sensitivity, and weight gain. High levels of thyroid hormones, seen in hyperthyroidism, can lead to shorter and lighter periods.
One in 10 women of childbearing age develops endometriosis. This is a condition in which tissue that normally grows in the uterus grows outside the uterus. Endometriosis causes very painful, even debilitating menstrual cramps. Endometriosis also causes heavy bleeding, prolonged periods, and bleeding between periods.
Obesity causes irregular periods. Being overweight affects hormones and insulin levels, interfering with the menstrual cycle. Rapid weight gain can also cause menstrual irregularities. Weight gain and irregular periods are common symptoms of PCOS and hypothyroidism and should be checked by a doctor.
Extreme weight loss
Excessive or rapid weight loss can cause menstrual periods to stop. Insufficient calorie intake can interfere with the production of hormones needed for ovulation.
Cervical and endometrial cancer
Cervical and endometrial cancers can cause changes in the menstrual cycle, with bleeding between periods or heavy periods. Bleeding during or after sex and unusual discharge are other signs and symptoms of these cancers.
Some medications can disrupt the menstrual cycle, some of which include:
- Hormone replacement therapy
- Blood thinners
- Epilepsy drugs
- Chemotherapy drugs
- Aspirin and ibuprofen
- Thyroid medications
Intense exercise disrupts the secretion of hormones. Athletes and women who do intense exercise and strenuous physical activity often cause amenorrhea. Reducing exercise and increasing calories can help regulate menstruation.
Stress can cause menstrual irregularities by temporarily interfering with the brain part that controls the hormones that regulate the menstrual cycle. After reducing stress, menstruation should return to normal. It is best to use stress reduction techniques to control stress.
How are missed or irregular periods diagnosed?
If you do not have a regular menstrual cycle, you should have an accurate record of when your period starts and ends, including the amount of blood flow and whether you are expelling large blood clots. Other symptoms include bleeding between periods and menstrual cramps or pain.
Your doctor will ask you about your menstrual cycle and medical history and perform a physical exam, including a pelvic exam and sometimes a Pap test. Your doctor may also order special tests, including the following:
- Blood tests to diagnose anemia or other medical disorders
- Vaginal cultures to look for infections
- A pelvic ultrasound exam to check for polyps, uterine fibroids, or an ovarian cyst
- An endometrial biopsy
You probably do not need special treatment for irregular periods unless your doctor determines after examinations that you need treatment. Hypothyroidism and Polycystic ovary syndrome are the two main causes of irregular periods in women.
The goal of treatment is to restore the balance of hormones in the body. If you have PCOS, your doctor may recommend birth control pills or other hormones. If you have hypothyroidism, you may need to take thyroid hormones. Other things that may help you have a regular period include:
- Changing birth control method: If you have an irregular period after three months of hormonal contraception, your doctor may recommend another type.
- Lifestyle changes: Lifestyle changes can make a positive difference in menstruation. If you exercise too much, you need to reduce it. If you have stress, you should use stress management methods. Severe weight changes can affect menstruation. Being overweight can also make it difficult for the body to ovulate. Proper nutrition, physical activity, and lifestyle modifications can help regulate menstruation.
- Hormone therapy: Irregular menstrual cycles are often due to a deficiency or imbalance of certain hormones in the body. Doctors often prescribe birth control pills containing estrogen and progesterone to help control irregular periods.
- Surgery: Occasionally, scarring or structural problems in the uterus or fallopian tubes can lead to irregular periods. Your doctor may recommend surgery to correct structural problems or birth defects, especially if you plan to have a baby. It may also be done to remove scar tissue in the reproductive tract.
Can you get pregnant with an irregular period?
Yes, sometimes, you can ovulate with irregular cycles. You will not get pregnant if you do not ovulate, but you can get pregnant with irregular cycles. You can bleed without ovulation, but you can only get pregnant if you ovulate.
When to call a doctor
Contact a gynecologist if you have any of the following symptoms:
- Miss three or more periods a year
- Get your period more often than every 21 days
- Get period less often than every 35 days
- Bleeding more heavily than usual during the period
- Bleed for more than seven days
- Have more pain than usual during menstruation
The bottom line
Irregular periods are sometimes very serious and may be a sign of a disease, even cervical cancer and other types of genital malignancies; Therefore, such disorders need to be followed up and treated, especially if the person is of childbearing age intends to become pregnant. If you have questions about the menstrual cycle or notice a change, it is best to consult your doctor and fix irregular menstruation.
Arjang Naim MD and his team get accurate records of women who have irregular periods. They also perform the necessary examinations and treatments to diagnose and maintain women’s health.
- What are the symptoms of PMDD?
- Anger or irritability
- Feeling on edge, overwhelmed, or tense
- Anxiety and panic attacks
- Depression and suicidal thoughts
- Difficulty concentrating
- Fatigue and low energy
- Food cravings, binge eating, or changes in appetite
- How painful is an endometrial biopsy?
An endometrial biopsy can be uncomfortable, but it is not considered painful. It is normal to have some cramping during the procedure.
- How many days is normal for missed periods?
Healthy cycles usually range from 21 to 35 days. Unless a medical condition is causing irregular cycles, most women probably have at least a rough idea of when to expect their next period. Menstruation is considered late if it has not started within seven days of the expected time.
- Can lack sleep delay periods?
Lack of sleep, in particular, affects stress hormones and melatonin levels. Melatonin is a hormone that helps regulate the onset of periods and cycle length. Because of this, changes in melatonin levels can affect the cycle.
- What hormone causes light periods?
Light periods are more common in women approaching menopause. This is because at this time, they produce less estrogen, the hormone responsible for regulating menstrual cycles.