IRREGULAR MENSTRUATION

Menarche is the first menstrual cycle or first menstrual bleeding in women.

Normal cycle: The normal length of a woman’s menstrual cycle is 28 days, but this varies between individuals. Irregular menstruation is when the length of the cycle is more than 35 days, or less than 21 days, generally.

Reproductive age: Periods usually start during puberty between the age of 10 and 16 years, and they continue until menopause when a woman is 45 to 55-years old.

A period, or menstruation, is the part of the menstrual cycle in which endometrium, which is the lining of the uterus, is shed in the form of bleeding through the vagina.

Irregular periods can occur if there is a change in contraception method, a hormone imbalance, around the time of the menopause, stress, weight and diet changes, PCOS, hypothyroidism, etc.

Causes:

Various factors that may be related to irregular cycles are mostly related to hormone production. The two hormones that impact menstruation are estrogen and progesterone that regulate the cycle.

Hormonal influences

Life cycle changes that influence the hormonal balance include puberty, pregnancy and childbirth, breastfeeding and menopause.

During puberty, the body undergoes major changes. It can take several years for the estrogen and progesterone to reach a balance, and irregular periods are common at a young age.

Periods are generally absent in pregnant and breastfeeding women.

Contraceptives can cause irregular bleeding. An intrauterine device (IUD) may cause heavy bleeding, whereas, the contraceptive pill can cause spotting between periods with small bleeds that are generally shorter and lighter than normal periods for the first few cycles of about 3-6 months and may go away after a few months.

Before menopause, women often have irregular periods, and the amount of bloodshed may decrease gradually, that may eventually stop. Menopause can be considered when a woman has no period for about 12 consecutive cycles.

Medical Conditions that are associated with irregular periods include:

  • Polycystic ovarian syndrome (PCOS) is a condition in which a number of small, fluid-filled sacs known as cysts develop in the ovaries.
  •  thyroid disorder can cause irregular periods. The thyroid gland produces hormones that affect the body’s metabolism.
  • extreme weight loss
  • extreme weight gain
  • emotional stress
  • eating disorders, such as anorexia or bulimia
  • Endurance exercise, for example, marathon running.

A number of other medical conditions are also linked to missed or irregular menstruation.

Endometriosis is a condition in which cells that are normally found inside the uterus, called endometrial cells, grow outside it. In other words, the lining of the inside of the uterus is found outside of it. If released blood gets stuck in the surrounding tissue, it can damage the tissue, causing severe pain, irregular periods, and infertility.

Pelvic inflammatory disease (PID) is an infection of the female reproductive system. Most common symptoms include bleeding between periods and after sex, lower abdomen pain, foul-smelling vaginal discharge, etc.

Cervical or uterine cancer (cancer of the womb) these may cause bleeding between periods, after menopause or during sexual intercourse.

Treatment

The primary mode of treatment may generally be directed towards treatment of the underlying cause or medical condition if needed.

Puberty and menopause: Irregular periods that occur during puberty or as the woman approaches menopause do not usually need treatment.

Birth control: If irregular bleeding is due to contraception, and if it continues for more than 3-6 months, discussing other options with a health-care professional may be a good idea.

PCOS and obesity: In cases of PCOS, overweight or obesity, losing weight may help stabilize menstruation. Lower weight means the body does not need to produce so much insulin. This leads to lower testosterone levels and a better chance of ovulating.

Thyroid problems: Treatment for the underlying problem is likely to be, that may include medication, radioactive iodine therapy or surgery.

Stress and eating disorders: Psychological therapy may help if emotional stress, an eating disorder, or sudden weight loss have triggered irregular periods. This may include relaxation techniques, stress management and talking to a therapist.

Endometriosis, PID: treatment is targeted to the underlying condition.

………………………………………………. Dr krishna priya

References

https://www.medicalnewstoday.com/articles/178635.php

https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menstrual-cycle/art-20047186?pg

Image Credits: Internet

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