Irregular Periods

Menstruation disorders affect a woman's normal menstrual cycle..Menstruel cycles or Periods vary widely from woman to woman. Some periods are punctual, some are unpredictable. In average it varies from 24 – 35 days and lasts 3 -5 days.They are common during adolescence and menopause.

A women observes Irregular Periods:
1/ when the time between periods is very irregular
2/ When the women is loosing more or less period than usual.
3/ or when the number of days varies for cycle to cycle.
These changes should always be discussed with a healthcare provider because they can signal underlying medical conditions and potentially have long-term health consequences
Amenorrhea is absence of menstrual periods, is either:
Primary, when menstrual periods have not started by age 15
Secondary, when menstrual periods are absent for more than six months in a woman who previously had periods
Oligomenorrhea is the medical term for infrequent menstrual periods (fewer than six to eight periods per year). Metrorrhagia refers to irregular but frequent periods. Menometrorrhagia refers to longer or heavier periods that are irregular but frequent.

How to investigate irregular/heavy periods?

First step will be to take a detailed medical history. Important aspects in the history are:

  1. The age, the duration of the problem, the length of the cycles and duration of bleeding, whether there are associated symptoms such as pain,, hot flashes,  breast discharges,  acne, facial or chest hair.
  2. Family history of irregular periods.
  3. Other medical problems such as any bleeding/clotting problems, history of easy bruising, known hormonal conditions and any medication used.
  4. Some women may increase or loose weight. Eating disorder or excessive exercise.
  5. Other may feel lumps in the lower part of their abdomen or experience frequent urination due to fibroids.
After the history the Doctor will need to do abdominal and pelvic examination including an ultrasound.
Will check the uterus, ovaries and other pelvic structures. Pap smear can be done if the bleeding occurs after intercourse. Occasionally a biopsy from the lining of the uterus is also done. The face, neck, breasts are also checked
Depending upon each case, the clinician may order blood tests to measure hormone levels , will make sure that the bleeding is not due to pregnancy.
In selected cases, a magnetic resonance imaging (MRI) test for the hypothalamic or pituitary gland or chromosomal analysis
Menstrual cycle disorders can result from conditions that affect the hypothalamus, pituitary gland, ovaries, uterus, cervix, or vagina and very rarely chromosomal.

Treatment for Irregular Periods.

Usually no treatment is needed for irregular periods caused by puberty unless they are excessive.
1/ Treating underlying disease. Most common are Polycystic ovaries and thyroid dysfunction.
Polycystic Ovary Syndrome: (PCOS) is a chronic condition that causes infrequent periods and an excess of androgens (male hormones).
Treating PCOS to reestablish normal menstrual cycles and prevent long-term complications is most of the time recommended.
Hypothyroidism is treated with supplementation of thyroid hormones.
Hypothalamic amenorrhea: Women with hypothalamic amenorrhea are sometimes able to resume normal menstrual periods after making certain lifestyle changes, such as eating a higher-calorie diet, gaining weight, reducing the intensity or frequency of exercise, and reducing emotional stress
Others are recommended estrogen and progestin hormone replacement to reduce the risk of developing osteoporosis later in life.
Ovarian Failure: Normally, a woman stops ovulating around the age of 50; this is called menopause. If a woman stops ovulating before age 40, this is called premature ovarian failure or primary ovarian insufficiency. Current practice is to provide hormone therapy for women with premature ovarian failure until age 50, the average age of menopause.
High Prolactin are cause of amenorrhea and can usually restore normal menstrual periods and become pregnant when treated with medications .
Anatomic Problems: are treated medically or surgicallyasuterine adhesions(Asherman Syndrome)or fibroid
2/ Changing Birth Control.
3/ Lifestyle Changes: Healthy life style can restore regular periods.