Irregular Periods Tips

Missing out on your periods or irregular periods once in a while is common. However, the problem arises when irregular periods become every month’s story. The irregularity can be an amalgamation of a host of factors. Ignoring the same for long will only complicate things further. For women of reproductive age, the problem can give rise to deleterious consequences, including difficulties in conceiving. In this article, we will discuss some of the common triggers that result in irregular periods and when to seek medical help.

What causes Irregular Periods?
The hormonal balance plays a significant role in the proper functioning of the vital organs of the body. More than often, irregular periods are found to be a manifestation of hormonal imbalance. Some of the conditions that trigger the hormonal imbalance include

• PCOS is a common medical condition that affects women of reproductive age. PCOS is characterized by the formation of cysts in the ovary (one or both) that affects the ovulation process. In PCOS, there is an increased production of Androgen, especially Testosterone that can cause irregular periods, hair fall, facial hair, weight gain etc.

• Time and again doctors and health professionals emphasize the importance of leading a stress-free life. Research suggests stress and anxiety often interfere with the functioning of the Hypothalamus. As a result, the pituitary glands that control and regulate the activities of the ovaries, adrenal glands, and thyroid glands may be affected. These can also trigger a hormonal imbalance giving rise to menstrual problems such as Irregular periods. In the case of extreme stress, there may be a short-term cessation of periods (Secondary Amenorrhea).

• The hormonal imbalance and irregular periods can also be an outcome of other medical conditions such as endometriosis, cancer affecting the reproductive organs, fibroids, obesity, diabetes, hyperprolactinemia (characterized by an elevated level of prolactin) or even thyroid disorders.

• Women who indulge in strict dieting can also suffer from irregular periods. Strict dieting (especially the ones that are without proper nutritional guidance) can rob the body of the essential nutrients disrupting the hormonal balance.

• Irregular periods are normal in women who are nearing their menopause.

When to seek medical assistance?
Irregular periods can be indicative of a severe health problem. Consult a gynaecologist

• If your regular cycles get delayed by more than 7 days.

• There is spotting or bleeding in between the periods.

• Your periods last for more than ten days or less than two days.

• There is excruciating pain during periods.

• The gap between two successive menstrual cycles is more than 35 days or less than 21 days.

• Your periods are heavy and unmanageable, affecting your daily routine.

Menstrual disorders are caused by a variety of factors and affect every woman in a different manner. In most cases, it manifests itself in the form of fluctuations in menstrual flow and irregularity in the monthly cycle. Certain disorders are not too severe and can be easily alleviated. Others are more complicated and require the immediate attention of a gynecologist.

As mentioned, there are different specific causes of different kinds of disorders resulting from a range of factors such as hormone levels, functioning of the central nervous system, health of the uterus, etc.

Some of the most common causes of menstrual disorders are as follows:

- Hormonal imbalance

Fluctuating hormone levels in the body have a direct impact on the menstrual cycle. These fluctuations can be caused by dysfunction in the pituitary gland, thyroid gland or adrenal gland. It can also be a result of malfunction in either or both ovaries and the secretion of hormones originating there.

- Anatomic problems

One fourth menstrual disorders are caused by problems of the anatomy. These include various gynecological issues like the presence of uterine fibroids and polyps, reduced uterine contractile strength, adenomyosis (intrusion of uterine tissue into the muscular wall of the uterus), a uterus with an excessively large surface area, and endometrial cancer.

- Clotting irregularities

Abnormality in clotting is a cause of heavy menstrual bleeding in women. It leads to exceeding blood loss from minor cuts and gashes and makes one easily prone to bruising. This may also include medical conditions such as thrombocytopenia (platelet dysfunction) and Von Willebrand disease.

- Medications and supplements

There is a wide range of medications and nutritional or hormonal supplements which often cause menstrual disorders in women and lead to fluctuations in the menstrual cycle. These include medicines such as aspirin, ibuprofen, estrogen pills, Vitamin E supplements etc.

- Miscellaneous factors

These are comparatively rare and require a greater degree of medical attention. It includes conditions such as cervical cancer, ovarian tumors, liver and kidney diseases, uterine infections, extreme psychological stress, obesity, etc. Incidents such as miscarriages and unsuspected pregnancies are also known to cause abnormal menstrual bleeding.  

Not getting your period on the expected date can make a woman nervous, especially if she is not planning a family. However, there is more than one reason for periods to be delayed or to be skipped. If this happens once in a while, you need not worry, but if your periods do not follow any sort of a schedule, you should see a gynecologist at once. Your body may be trying to tell you something. Here are a few of those messages that you may be missing.

1. You may be too stressed out: In most cases, irregular menstrual cycles are triggered by high stress levels. Stress makes the body produce cortisol which has a direct effect on the production of estrogen and progesterone. It also interferes in the communication between the hypothalamus and the pituitary gland. This causes the hormone communication system in the body to shut down.
2. You aren’t having a balanced diet: Your diet also plays an important role in your menstrual cycle. If you have gained excessive weight recently or indulge in a carb heavy diet, the hormone levels in your body will fluctuate thereby, changing your ovulation date. In order to maintain a regular menstrual cycle, a woman’s BMI should be between 17-22 percent.
3. You are exercising too much: Sudden weight loss, excessive exercising and being underweight can also affect the body’s hormone levels just as being overweight affects them. Some hormones are produced only in fatty tissue and a sudden drop in fatty tissues can lower the production of these hormones leading to irregular periods. A sudden spurt of excessive exercising can also drain your body of energy leaving it with no energy to menstruate.
4. You may be suffering from polycystic ovarian syndrome: Missed or late periods are often also a sign of polycystic ovarian syndrome or PCOS. Look out for other symptoms of this condition such as weight gain, dandruff or excessive hair growth to diagnose this condition. PCOS needs medical attention so it is best to get yourself diagnosed correctly by a gynecologist.
5. Your medication may be interfering with your hormones: Many types of medication interfere with the body’s production of estrogen and progesterone. Even simple over the counter medication can make your periods late by a few days.
6. You may be menopausal: Lastly, if you definitely aren’t pregnant and are above the age of 40, you may be turning menopausal. As a woman turns menopausal, ovulation becomes sporadic and in turn influences periods to be irregular as well.

Irregular menstruation is a common problem. Just like the downtime that women face during their bleeding, the absence of it or the uncertainty of when the periods will start also causes equal stress and worry. Irregularity in the menses is indeed a cause for concern and requires a medical intervention. Before proceeding to the times when one should consult a doctor, let’s first understand the causes of an irregular menstrual cycle.

Causes of Irregular Menses: Irregularity in the menses can be pretty normal in some cases. For example, when the menstrual cycle begins for a girl, before menopause, and a few times after childbirth, abortion, or miscarriage, it is normal to miss periods. But, apart from these times, irregularity in the menstrual cycle is not normal and a doctor should be consulted.  There are several reasons that can contribute towards irregular menses, including the following:

• Eating disorder: Eating disorders such as bulimia or anorexia may cause an irregular menstrual cycle. This is due to the fact that the body is not producing enough hormones to regulate the menstrual cycle.
• Hyperprolactinemia: The presence of too much of prolactin, a protein hormone, in the blood can lead to irregular periods.
• Polycystic ovary syndrome: The imbalance of the sex hormone leads to the development of polycystic ovary syndrome, commonly referred as PCOS. This disrupts the regular menstrual cycle.
• Premature ovarian failure: Premature ovarian failure implies that the ovaries of a woman have stopped functioning before the age of 40 years is attained by the woman. In some cases, women do have menses, but occasionally.
• Unmanaged diabetes: Uncontrolled diabetes is another cause that can lead to irregular periods. This is due to the interaction of the hormones with the blood sugar levels, which disrupts the menstrual cycle.
• Medications: Irregular menses may also result due to the effect of certain medicines. These medicines include antipsychotics and antiepileptics.

Why consult a doctor?
It is extremely important to understand when one should consult a doctor to address the problem of an irregular menstrual cycle. For a woman who is of reproductive age, the following are some instances when a doctor should be consulted:

• Amenorrhea: It is the absence of menses for a minimum of 3 menstrual cycles. Oligomenorrhea: It implies having a menstrual cycle more than 35 days apart. Menorrhagia: It implies heavy bleeding for more than a week. The unusual bleeding or no bleeding at all may result due to the following conditions, which can only be diagnosed by an experienced gynecologist.
• Endometriosis: This is a condition that occurs when the endometrial tissue starts to develop in other areas of the body like the ovaries, between the vagina and also the rectum. Painful and heavy menstruation flow signals this condition, which can lead to inflammation in the abdomen, bowel problems, and also infertility.
• Uterine Polyps: Polyps are benign growths in the lining of the uterus and may occur due to the overproduction of hormones. Heavy or light spotting between periods can be an indication of uterine polyps.
• Fibroids: Benign tumors found in the uterus are called fibroids. These are formed due to the stimulation of estrogen that leads to the formation of uterine tissue. In general, no symptoms are witnessed and they either go away with pregnancy and menopause or they get smaller in size over a period of time.

The amount of emotional upheaval that periods, or no periods (for that matter) can cause, is something that every woman is aware of. It's normal to miss your period for different reasons occasionally, but it is a matter of concern if this absence persists over a period of time.

The condition is then termed as a case of secondary amenorrhea. Although most people are quick to consider pregnancywhile dealing with the various reasons for missed periods, there are a number of possibilities which are seldom mulled over, but should be considered in order to take effective precautions and seek proper medical care:

1. Weight: Body weight is responsible for affecting hypothalamus and this may, in turn, upset your menstrual cycle. BMI level under 18-19 may result in triggering irregularities since enough estrogen will not be created. This is also why underweight women, who suffer from bulimia or anorexia, tend to miss their periods frequently. On the other hand, overweight women may stop ovulating due to increase in the production of estrogen and therefore, have heavy, infrequent periods. Therefore, it is essential that body weight be regulated to avoid any disappointment at 'the time of the month.'
2. Stress: Any type of physical or emotional stress is bound to affect your cycle. This is because, the production of stress hormones in the body increases and an elevated level of adrenaline and cortisol may impair the functioning of the reproductive system. Under stressful situations, the body employs its amino acids to assist the neurotransmitters to produce stress hormones over sex hormones. As a consequence, the chances of missing your periods increase.
3. Exercising Too Much: While regular workout is indispensable for battling a sedentary lifestyle, overdoing it might cause your body to produce lesser estrogen and delay your periods. Women, who are into athletics and gymnastics, are more likely to suffer from amenorrhea. In fact, other aspects of over-exercising, like sleeping less, fasting, and infections also contribute to such irregularities.
4. Breastfeeding: Prolactin is the hormone that aids in milk production and may also repress ovulation for a while. Many breastfeeding moms may not get their periods for a month or more as a result. But this doesn't do away with your chances of getting pregnant. A span of three months is expected to pass before the abnormalities are done away with.
5. Food Allergies: Celiac disease or untreated gluten allergy can directly harm hormone production. They are directly related to your gut health and your adrenal glands which is why they can influence the sex hormone creation.

Vaginal issues are usually connected with anomalies when it comes to discharging and even hormonal imbalances. A lot of ladies experience irregular vaginal bleeding or spotting between periods at some point in their lives. However, the periods might at times be irregular. Sometimes the bleeding is irregular and can occur at any age. Abnormal vaginal bleeding outside your menstrual cycle is called metrorrhagia and should be reported to a doctor immediately. In case it is accompanied by light-headedness, extreme pain or fever, urgent medical intervention might be needed. The bleeding is said to be abnormal when you are suffering from:

1. Unexpected periods
2. When your menstrual flow is lighter or heavier than usual
3. When it is not expected like before age 9, when you are pregnant, or after menopause

Causes: Some of the most common causes of this abnormal bleeding could be:

• Growth in the uterus or cervix
• Stress
• Medication change
• Premature delivery
• Miscarriage
• Vaginal dryness
• Cancer
• Hormone imbalance
• Ovulation
• Polycystic ovary disorder (PCOS), a hormonal imbalance.
• Contraceptive pills
• Infection
• Possible pregnancy

Medical Help: Since abnormal bleeding could be a cause for concern, one must consult a doctor. Neglecting to see a specialist can worsen the problem. There is no home treatment for unusual vaginal bleeding. The treatment might depend on a number of factors. It includes the cause of bleeding, your age and whether you have children. Most of the women can be easily treated with medication while some of them might need surgical attention. With a few types of vaginal bleeding, it might be all right to hold up to check whether the draining stops or not. Check your symptoms to choose if you need to see a specialist.

Medication: Medicines for the treatment of abnormal vaginal bleeding depend upon the cause. Some of the treatments are as follows:

1. In case the reason for the bleeding is the absence of ovulation (anovulation), specialists may prescribe progesterone.
2. In the event that the reason for the bleeding is a precancerous or change in the coating of the uterus, progesterone medicines are prescribed.
3. In case the reason is polyps or other kinds of growth, they are then removed surgically.
4. In these cases, oral contraceptives can enhance cycle control and diminish dying.
5. If the bleeding is excessive and cannot be controlled by any medicines, a surgical called dilation and curettage (D&C) might be vital.
6. A hysterectomy is required when hormonal drugs can't control excessive bleeding.

A patient needs to make sure that only a professional should prescribe the medicines. One should not take over-the-counter medicines.

Menstrual disorders are caused by a variety of factors and affect every woman in a different manner. In most cases, it manifests itself in the form of fluctuations in menstrual flow and irregularity in the monthly cycle. Certain disorders are not too severe and can be easily alleviated. Others are more complicated and require the immediate attention of a gynecologist.

As mentioned, there are different specific causes of different kinds of disorders resulting from a range of factors such as hormone levels, functioning of the central nervous system, health of the uterus, etc.

Some of the most common causes of menstrual disorders are as follows:

1) Hormonal imbalance

Fluctuating hormone levels in the body have a direct impact on the menstrual cycle. These fluctuations can be caused by dysfunction in the pituitary gland, thyroid gland or adrenal gland. It can also be a result of malfunction in either or both ovaries and the secretion of hormones originating there.

2) Anatomic problems

One fourth menstrual disorders are caused by problems of the anatomy. These include various gynecological issues like the presence of uterine fibroids and polyps, reduced uterine contractile strength, adenomyosis (intrusion of uterine tissue into the muscular wall of the uterus), a uterus with an excessively large surface area, and endometrial cancer.

3) Clotting irregularities

Abnormality in clotting is a cause of heavy menstrual bleeding in women. It leads to exceeding blood loss from minor cuts and gashes and makes one easily prone to bruising. This may also include medical conditions such as thrombocytopenia (platelet dysfunction) and Von Willebrand disease.

4) Medications and supplements

There is a wide range of medications and nutritional or hormonal supplements which often cause menstrual disorders in women and lead to fluctuations in the menstrual cycle. These include medicines such as aspirin, ibuprofen, estrogen pills, Vitamin E supplements etc.

5) Miscellaneous factors

These are comparatively rare and require a greater degree of medical attention. It includes conditions such as cervical cancer, ovarian tumors, liver and kidney diseases, uterine infections, extreme psychological stress, obesity, etc. Incidents such as miscarriages and unsuspected pregnancies are also known to cause abnormal menstrual bleeding.  

Menstrual disorders are caused by a variety of factors and affect every woman in a different manner. In most cases, it manifests itself in the form of fluctuations in menstrual flow and irregularity in the monthly cycle. Certain disorders are not too severe and can be easily alleviated. Others are more complicated and require the immediate attention of a gynaecologist.

As mentioned, there are different specific causes of different kinds of disorders resulting from a range of factors such as hormone levels, functioning of the central nervous system, health of the uterus, etc.

Some of the most common causes of menstrual disorders are as follows:

- Hormonal imbalance

Fluctuating hormone levels in the body have a direct impact on the menstrual cycle. These fluctuations can be caused by dysfunction in the pituitary gland, thyroid gland or adrenal gland. It can also be a result of a malfunction in either or both ovaries and the secretion of hormones originating there.

- Anatomic problems

One-fourth menstrual disorders are caused by problems of the anatomy. These include various gynaecological issues like the presence of uterine fibroids and polyps, reduced uterine contractile strength, adenomyosis (intrusion of uterine tissue into the muscular wall of the uterus), a uterus with an excessively large surface area, and endometrial cancer.

- Clotting irregularities

Abnormality in clotting is a cause of heavy menstrual bleeding in women. It leads to exceeding blood loss from minor cuts and gashes and makes one easily prone to bruising. This may also include medical conditions such as thrombocytopenia (platelet dysfunction) and Von Willebrand disease.

- Medications and supplements

There is a wide range of medications and nutritional or hormonal supplements which often cause menstrual disorders in women and lead to fluctuations in the menstrual cycle. These include medicines such as aspirin, ibuprofen, estrogen pills, Vitamin E supplements etc.

- Miscellaneous factors

These are comparatively rare and require a greater degree of medical attention. It includes conditions such as cervical cancer, ovarian tumors, liver and kidney diseases, uterine infections, extreme psychological stress, obesity, etc. Incidents such as miscarriages and unsuspected pregnancies are also known to cause abnormal menstrual bleeding.  

Menstrual disorders are caused by a variety of factors and affect every woman in a different manner. In most cases, it manifests itself in the form of fluctuations in menstrual flow and irregularity in the monthly cycle. Certain disorders are not too severe and can be easily alleviated. Others are more complicated and require the immediate attention of a gynecologist.

As mentioned, there are different specific causes of different kinds of disorders resulting from a range of factors such as hormone levels, functioning of the central nervous system, health of the uterus, etc.

Some of the most common causes of menstrual disorders are as follows:

1. Hormonal imbalance: Fluctuating hormone levels in the body have a direct impact on the menstrual cycle. These fluctuations can be caused by dysfunction in the pituitary gland, thyroid gland or adrenal gland. It can also be a result of malfunction in either or both ovaries and the secretion of hormones originating there.
2. Anatomic problems: One fourth menstrual disorders are caused by problems of the anatomy. These include various gynecological issues like the presence of uterine fibroids and polyps, reduced uterine contractile strength, adenomyosis (intrusion of uterine tissue into the muscular wall of the uterus), a uterus with an excessively large surface area, and endometrial cancer.
3. Clotting irregularities: Abnormality in clotting is a cause of heavy menstrual bleeding in women. It leads to exceeding blood loss from minor cuts and gashes and makes one easily prone to bruising. This may also include medical conditions such as thrombocytopenia (platelet dysfunction) and Von Willebrand disease.
4. Medications and supplements: There is a wide range of medications and nutritional or hormonal supplements which often cause menstrual disorders in women and lead to fluctuations in the menstrual cycle. These include medicines such as aspirin, ibuprofen, estrogen pills, Vitamin E supplements etc.
5. Miscellaneous factors: These are comparatively rare and require a greater degree of medical attention. It includes conditions such as cervical cancer, ovarian tumors, liver and kidney diseases, uterine infections, extreme psychological stress, obesity, etc. Incidents such as miscarriages and unsuspected pregnancies are also known to cause abnormal menstrual bleeding.

What are heavy periods?

‘Heavy periods’ are described as excessive bleeding during menses over several menstrual cycles in a row that interfere with the quality of life. The amount of blood that is lost during a woman’s period varies from one person to another, making it difficult to give a general description of heavy periods.

What are the signs and symptoms of heavy periods?

Blood loss with your periods that requires you to change your sanitary wear (pads or tampons) frequently (every one to two hours or more), especially when you are using large sanitary pads, super plus tampons or night time towels.

1. Periods that last more than seven days
2. Passing blood clots during periods
3. Feeling tired and drained during and just after your period
4. A diagnosis of anaemia
5. 'Flooding' – when bleeding is so heavy that seating or sheets become soaked with blood while sitting or lying down.

What causes heavy periods?

In women from 25 to 40 years of age, over three-quarters (80%) with heavy periods have no underlying cause. However, the conditions listed below can sometimes be the cause of heavy periods:

• Endometrial polyps or uterine fibroids – Benign (non-cancerous) growths in the womb (uterus). Fibroids are usually bigger than polyps.
• Endometriosis – The cells that line the inside of the womb are called the endometrium. Endometriosis is when these cells are present outside the womb, such as on the ovaries or fallopian tubes. This may cause heavy periods associated with period pain, painful sex and chronic pelvic pain.
• Intra-uterine device (IUD) – The coil inserted into the womb as a method of contraception can increase blood loss during periods by almost half (40 to 50%).
• Chronic pelvic inflammatory disease (PID) – An ongoing infection in the pelvic area of the body.
• Polycystic ovarian syndrome (PCOS) – A condition of having multiple cysts in the ovaries, causing heavy, irregular periods, and sometimes an increase in weight and facial hair.
• Endometrial hyperplasia – When the endometrium is thicker than usual in response to an excess of oestrogen.
• Cancer of the lining of the womb – This is very rare, but can also cause heavy periods.

What treatments are available?

Drug treatments:

1. Levonorgestrel intrauterine system (Mirena IUS) – This is a small plastic device that is inserted into the womb and slowly releases a small amount of the progesterone hormone.

2. Tranexamic acid tablets – These pills can reduce the heaviness of period bleeding by almost half (40 to 50%).

3. Non-steroidal anti-inflammatory drugs (NSAIDs) – These come in various types, with mefenamic acid being the most commonly prescribed.

4. Combined oral contraceptive pill (COC) – This reduces period bleeding by almost a third (30%) in some women. We will provide a prescription for the first four weeks and your GP will prescribe the tablets after this time.

6. Oral progesterone –This is a hormone pill which works by preventing the womb lining from growing quickly.

Surgical treatments:

Surgical treatments are only considered when medical treatments are not effective.

1. Endometrial ablation – This involves the destruction of the endometrium. The aim is to prevent the endometrium from thickening.
2. Hysterectomy – The surgical removal of the womb. Hysterectomy is not commonly used to treat heavy periods.
3. If you have fibroids there are other surgical treatments, such as fibroid removal, (Myomectomy) or uterine artery embolization (blockage of blood supply).