Have you ever wondered, “Why are my periods so irregular and what can I do about it?“
First of all, reassure yourself that you’re not alone. More importantly, we have asked our expert Dr Aanchal Sablok who holds an MS (OBG), DNB(OBG) and a Fellowship in Fetal Medicine (FMF UK), to decode irregular period cycles for you!
What does it mean to have irregular menstruation? What is a normal menstrual cycle?
A normal menstrual cycle ranges from 21 to 35 days starting from the 1st day of your periods. The mean cycle length is usually 28 days. A woman menstruates around 80ml of blood during periods that can last for up to 4 to 5 days. Any alteration of cycle length i.e. a cycle length of less than 21 days or more than 35 days is said to be indicative of irregular periods.
Irregular periods is a very common complaint, especially in women of reproductive age group.
Reasons for irregular periods
There are several physiological as well as pathological reasons for irregular periods.
Physiological reasons for irregular periods
Irregular periods in teenage (Puberty)
The first physiological reason for irregular periods is puberty(the first bleed). When a girl attains puberty, her periods for the initial 2 years can be a bit irregular which is completely normal. As the ovaries mature, the periods become normal on their own.
The second most common physiological reason is pregnancy. When a woman conceives, her periods stop for the next nine months. Sometimes in early pregnancy,implantation bleeding may occur resulting in irregular periods requiring to date the pregnancy as per the first trimester NT/NB scan.
Post childbirth, periods in the postpartum phase come after 3 weeks or 3 months depending upon her lactating status. During lactation, there is an upsurge of prolatin levels in the body which leads to either complete cessation of periods or irregular periods. When a women is exclusively breastfeeding, her periods generally stop, technically labelled as lactational amenorrhoea. It is only after she stops exclusive breastfeeding the prolactin levels drop in the body leading to attainment of her periods again. For the first few months, the periods can be irregular but this is considered physiological and normal.
As the age advances, there is an aging of the ovaries as well. The ovaries stop responding to the hormones produced by the brain to form a mature egg. As a result of this, the periods become irregular and this is considered normal.
Pathological reasons for irregular periods
Polycystic ovarian syndrome is a very common entity encountered in young girls and young women. This is a condition leading to excess estrogen production in the body. This estrogen acts on the endometrial lining of the uterus leading to delayed orprolonged periods.
It has been seen that high levels of thyroid in the body can lead to irregular periods.
It has also been seen that women who are obese and suffer from metabolic syndrome encompassing high sugars (fasting/PP), high cholesterol, LDL, low HDL and high thyroid levels have an excess amount of estrogen in the body along with polycystic ovaries. They quite often suffer from irregular periods.
Fibroids are found in approximately 70% of women of the reproductive age group. Fibroids can be asymptomatic or symptomatic. Large fibroids which are inside the muscle of the uterus can lead to painful and heavy flow during periods. Fibroids which are inside the endometrium of the uterus are called as polyps and can also lead to painful and bleeding in between periods (irregular periods).
Endometriosis is nowadays a common pathological condition that leads to implantation of the endometrial lining of the uterus at places other than the uterus. This can lead to painful and irregular periods.
Cysts in the ovaries
Many times after periods, a cyst forms in the ovary which can be haemorrhagic in nature or be a remanant of the follicle after ovulation (functional cyst). These cysts usually subside on their own, but when present for a longer duration, can lead to irregular periods.
Pathological conditions of the ovaries like tumors of the ovaries or cancers of the ovaries can lead to loss of weight, decrease appetite as well as cause irregular periods.
Cancers of the endometrial lining of the uterus leads to prolonged and irregular periods.
Irregular Periods Treatment
Irregular periods, if physiological, can be quite easy to deal with. Following are the measures that can be taken to deal with irregular periods.
Maintaining a menstrual calendar
Sometimes, women get periods twice in one month but at a gap of 21 to 28 days, which is perfectly normal. However, this can produce the anxiety of having irregular periods. Maintaining a menstrual calendar just to track the periods can be of great help to alleviate unnecessary tension.
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Maintaining a healthy lifestyle
It has been shown that reducing at least 10 kgs of weight can lead to attainment of regular periods. Brisk walking for approximately 30 to 40mins per day can lead to buildup of muscles and reduction of fat in the body.
Reducing carbohydrates and sugars
Carbohydrates and sugars are the main culprit of weight gain and the reason behind metabolic syndromes. Reducing carbohydrates, sugars and refined oils in your diet can go a long way in dealing with irregular periods.
Adding antioxidant-rich foods in the diet can lead to maintenance of healthy ovaries. There has been scientific evidence to suggest that the addition of wheatgrass, berries and vitamin E in the diet can not only deal with premenstrual syndrome (PMS) but also deal with irregular periods.
When should I visit a doctor for irregular periods?
- In case of painful and irregular periods that lasts for more than 3 months, it is advisable to visit your gynaecologist for examination and investigations to rule out pathological conditions behind irregular periods.
- If you are planning pregnancy and have missed your periods, visit your gynaecologist at the earliest for confirmation of viable intrauterine pregnancy and for further management.
- If your periods are irregular as well as painful, this is another reason not to miss out on regular gynaecological check ups.
- Any mass felt in the abdomen along with irregular periods can be a red flag to consultyour doctor at the earliest.
- In case of advanced age, it is highly recommended to visit the gynaecologist at the earliest to deal with conditions that may need intervention for definitive management.
Have you experienced irregular periods? Was it physiological or pathological? Let us know in the comments below!