Irregular Periods

What to Do When Having an Irregular Period

During your menstrual cycle each month, your body releases unfertilized eggs. Your estrogen and progesterone levels rise and thicken the lining of your uterus to protect the eggs if they become fertilized. If none of the eggs are fertilized, your body sheds the excess lining in the form of your monthly period.

Typically, a woman has her period every 24 to 31 days, lasting between four and seven days, and losing approximately four to 12 tablespoons of blood. But not all women have typical periods.

Some women completely miss or have irregular periods. You may have more or fewer periods, your periods may be shorter or longer, or you may lose more or less blood. These conditions can be caused by chronic medical issues or by changing medical or emotional circumstances. In most cases, the condition causing irregular periods can be resolved or treated.

Some causes of irregular periods include:

  • Hormonal abnormalities
  • Medications
  • Problems with pelvic organs
  • Excessive weight gain or loss
  • Eating disorders
  • Increased exercise
  • Extreme emotional stress
  • Travel
  • Illegal drug use
Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS) is a condition that results from abnormal levels of certain hormones, causing women to have irregular or no menstrual periods. PCOS is a genetic condition, meaning that you were born with it. You may have a family member with PCOS and it may affect your children.

In some women, hormone changes may begin as early as their first menstrual cycle. In other women, changes occur over time. There is no cure for PCOS, but its symptoms can be treated and may include:

  • Excess hair on the face and body
  • Acne
  • Darkened color and change in texture of the skin along the neck, armpits, groin and inner thighs
  • Obesity
  • Irregular periods or no periods
  • Trouble getting pregnant
  • Vaginal yeast infections
  • Hair loss

To diagnose your PCOS, your doctor will ask you questions about your health, your menstrual cycle, and your family history. A complete exam will be conducted, including blood tests to check your hormone and insulin levels and an ultrasound to look at your ovaries. PCOS is a lifelong condition and treatment depends on your symptoms and whether you want to become pregnant. Long-term treatment may be needed if other medical problems, such as heart disease, diabetes and high blood pressure, arise. Changes in lifestyle such as exercise, weight loss, and a low carbohydrate diet can relieve your PCOS symptoms.

Anovulation

Ovulation, releasing a mature egg from the ovary, is a normal part of the reproductive cycle. It usually starts around your first menstrual period and stops with menopause. Anovulation is the term used when you are not ovulating. Signs of anovulation include lack of periods, irregular periods, and abnormal bleeding either between or during your periods.

Sometimes no specific cause can be discovered for anovulation. In other cases, your doctor can determine that your lack of ovulation is due to:

  • Polycystic ovarian syndrome (PCOS)
  • Problems with the central nervous system brought about by:
  • Extreme stress
  • Excessive physical exercise
  • Excess weight
  • Overeating
  • Travel
  • Low thyroid hormone level
  • Aftereffects of using certain drugs such as oral contraceptives
  • Overproduction of the hormone prolactin
  • Primary ovarian failure (POF)

The good news is that once the cause of anovulation is determined, it can be successfully treated with medication in the vast majority of cases.

Menorrhagia

Menorrhagia is defined as excessive menstrual bleeding. It occurs in one out of every five women. Your period is considered excessive if:

  • Bleeding lasts longer than seven days.
  • Bleeding affects your daily activities.
  • Double protection (a tampon and a pad) is needed.
  • Your tampon or pad needs to be changed more than every two hours.

During a heavy period, you may:

  • Feel tired and nauseated
  • Feel depressed or moody
  • Experience severe cramps
  • Have headaches

While heavy periods are normal for some women, there are also medical causes for menorrhagia. These include:

  • Hormonal imbalances
  • Fibroids and polyps inside your uterus
  • Infections
  • Bleeding disorders that impair blood clotting

Once the cause has been identified, there are many treatment options available. If you plan to have children, your doctor may recommend both hormonal and non-hormonal drug therapy to help reduce your heavy periods. If you do not plan to have children, there are several surgical options that can relieve or eliminate menorrhagia. Talk with your doctor to determine the treatment option that is best for you. In addition, lifestyle changes such as a healthy diet, yoga, exercise, and acupuncture have been shown to reduce menstrual bleeding in some women.

Amenorrhea

Some women never start menstruating during their teenage years. Others who have had regular periods may stop having them. Not starting or not having a period is called amenorrhea.

There are several possible reasons for a missed period:

  • Sudden change in weight
  • Stress
  • Extreme exercise, such as running long distances each day
  • Hormone problems
  • Taking certain medications, such as birth control pills or cortisone
  • Illness

If you miss three periods in a row and are not pregnant, you should see your doctor to determine the cause of your skipped periods. The doctor will ask questions about your health and your lifestyle to determine whether or not your amenorrhea is due to medical or emotional reasons. In either case, most cases of amenorrhea end on their own or with the help of medication. You should also see your doctor if you have not started having periods by the age of 16.

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