Irregular menstruation Treatment

What is irregular menstruation?

Nearly all individuals and women who are assigned to be FAB (female at birth) experience menstrual cycles lasting 4-7 days, occurring roughly every twenty days. However, cycles ranging from twenty-one to thirty-five days are also considered normal, with the average being twenty-nine days. Variations in medical conditions, levels of hormones, stress, lifestyle factors, and medications can all influence the regularity of menstrual cycles.

Irregular menstruation examples

Even with slight variations, a cycle can still be deemed regular. However, the following are considered examples of irregular periods:

• Spotting or bleeding between periods, after sexual activity, or post-menopause.
• Menstrual bleeding that is significantly lighter or heavier than usual
• Cycles shorter than 3 weeks or longer than 5 weeks.
• Needing to change a tampon or pad more than once per hour due to heavy flow.
• A cycle length that varies by more than nine days (e.g., one cycle is 5 weeks+, the next 4 weeks+, and the following 3 weeks).
• Missing three or more consecutive periods.
• Periods lasting longer than 1 week.
• Severe pain, cramping, nausea, or vomiting during periods.

Minor fluctuations in menstrual cycles are normal and don't necessarily indicate a health concern. However, if irregularities persist, it's wise to seek medical advice.

When to seek medical advice

Consult a medical professional if you experience:

• Suspected pregnancy or difficulty conceiving.
• Painful or irregular periods.
• Severe cramping, nausea, or other unusual symptoms.
• Unusually heavy bleeding or large clots.
• Periods lasting longer than seven days.
• Spotting after menopause or between periods.

Circumstances linked to irregular menstruation

Several medical conditions can result in irregular menstruation, including:

• Oligomenorrhoea: menses do not occur regularly, with intervals of fewer than six to eight periods annually or over 5 weeks.
• Amenorrhoea: This refers to the complete absence of menses for approximately three months or more, unrelated to pregnancy, breastfeeding, or menopause. Failure to start menstruating by the age of 15 or 3 years after breast development is also classified as amenorrhoea.
• Abnormal uterine bleeding: This includes heavy bleeding, spotting between periods, or prolonged menstrual cycles.
• Dysmenorrhoea: This term describes excruciating menses accompanied by severe cramping. While mild uneasiness during menses is common, severe pain may indicate an underlying condition.

Causes of irregular period

Lifestyle as a cause of irregular menses

Daily habits and routines also affect menstrual cycles. Contributing factors include:

• Infections or illness
• Intense physical activity, especially in athletes and dancers
• Stress
• Sudden weight changes

Medical issues

Certain health conditions may lead to irregular periods, including:

• Primary ovaries are not sufficient: In women under 40, ovarian dysfunction may result in missed periods, often linked to autoimmune disorders or cancer treatments.
• Disorders of the pituitary and thyroid: Hormonal imbalances caused by these conditions can disrupt menstrual cycles.
• Cancers: Uterine or ovarian cancers can alter menstrual flow.
• Endometriosis: This occurs when uterine tissue grows outside the womb, often attaching to the ovaries or fallopian tubes, causing pain and abnormal bleeding.
• PCOS (Polycystic Ovary Syndrome): A condition in which excessive androgens interfere with ovulation, leading to irregular or absent periods.
• PID (Pelvic Inflammatory Disease): A bacterial infection, often linked to untreated sexually transmitted infections (STIs), that can disrupt menstruation.
• Bleeding disorders: Such as clotting disorder, which can result in heavy flow during menses.

Other conditions that can cause abnormal menstruation include:

• Surgical procedures: Scarring or blockages in reproductive organs may lead to irregular periods.
• Contraceptive pills: Hormonal contraceptives can affect cycle regularity, particularly when starting or stopping use.
• Medication: Including anticoagulants and steroids.
• Complications during pregnancy: Such as miscarriage or ectopic pregnancy.

Diagnosing irregular menstruation

Tracking your cycle is an essential step. Record the start and end dates, symptoms, and flow characteristics. When consulting a medical professional, they may perform a physical exam, as well as a pelvic examination, and recommend other tests such as:

• Endometrial biopsy: This test evaluates hormonal imbalances or precancerous cells. It is performed by using a simple tissue from the womb lining.
• Hysteroscopy: This test diagnoses abnormal bleeding by examining the uterus.
• Pelvic ultrasound: This is performed to identify ovarian cysts, uterine fibroids, or polyps.

Managing and treating irregular period

Treatment options depend on the core causes.

Medications used for irregular menstruation

• Pain relief: Over-the-counter medications like ibuprofen can ease mild to moderate cramps.
• Antibiotics use: Antibiotics are used to treat infections causing irregular bleeding.
• GnRH (gonadotropin-releasing hormone) agonist: The medication controls abnormal bleeding and reduces the size of the fibroid in the uterus.
• Hormonal contraceptives: Regulates cycles and manages abnormal or excessive bleeding.
• Hormonal therapy: It may alleviate irregularities during perimenopause, though risks should be discussed.
• Tranexamic acid use: Reduces heavy menstrual flow when taken at the onset of periods.

Surgical options for an irregular period

For severe cases, surgical intervention may be required:

• Occlusion of the uterine artery: Cuts off the blood supply to the fibroid.
• Hysterectomy: Reserved for extreme cases to remove the uterus. It is the last resort if the womb has suffered severe damage.
• Myomectomy: Removes fibroids while preserving fertility.
• Removal of the endometrium: Destroys the lining of the uterus to abnormal bleeding

How to prevent irregular periods and self-care recommendation

To minimise the risk of irregular periods:

• Change sanitary products every four to six hours to prevent infections.
• Maintain a balanced diet and healthy lifestyle.
• Avoid extreme dieting or excessive exercise.
• Practice stress management techniques.
• Use contraceptives as directed.

For more information or to discuss treatment options, book an appointment with our expert team today. Contact us for a personalised consultation.

FAQs

When can an individual experience irregular periods?

Irregularities are often seen during perimenopause (around age 50) or the onset of menstruation (ages 9–14)

Is it normal to miss periods for two months?

Missing one or two cycles might not be concerning. Factors like stress, weight changes, or new routines can influence periods. However, missing three or more cycles warrants a consultation with your healthcare provider.

Should I be worried about irregular menstruation?

While occasional irregularities may not be serious, persistent issues could indicate underlying problems. Consult a gynaecologist for peace of mind and treatment if necessary.

How much delay in menstruation is considered normal?

Slight delays are common. However, sudden and significant cycle length or flow changes should be evaluated.