Put a period to this irregularity

Dr Nitasha Gupta

Many young women face the problem of irregular periods at some point of time in their reproductive years. This issue can have many underlying causes. In fact, it can be a symptom of a serious medical problem like a malfunctioning thyroid, hormonal imbalance, PCOD, etc. For many women, irregular periods may be an early symptom of infertility. Whatever the cause or the reason, an early diagnosis and treatment are necessary. 

What is an irregular period

• It comes more frequently than 21 days.
• You go 35 days or more between two menstrual cycles.
• The length of menstrual cycle varies.

Myths and facts

The 28-day cycle: The most common myth is a 28-day menstrual cycle that is considered “normal”. If your cycle is shorter or longer than 28 days, it is considered irregular. However, this is not accurate. A 28-day cycle is an average menstrual cycle. Periods are irregular when the cycle is more than 35 days or less than 21 days. Any other number that falls between 21 and 35 is considered normal.

While an irregular cycles may signal a fertility problem, regular cycles cannot guarantee perfect fertility either. There are many causes of female infertility, and many of them are related to menstruation but not all impact it.

Occasional irregular periods

If your periods are frequently irregular, this may signal some problem. However, if the periods are irregular occasionally, it can be due to some normal health issues.

Healthy women may miss or have irregular period if they:

• Experience illness, including flu or cold, fever, etc.
• Are under stress
• Are travelling, especially if their sleep patterns have been thrown off
• Are breastfeeding, which in the early days may cause lactational amenorrhea (a condition with total lack of periods)
• Are pregnant

Factors behind irregularity

In many cases, irregular periods are related to a condition called anovulation. It happens when the ovaries do not release an oocyte (egg cell) during a menstrual cycle. Therefore, ovulation does not take place. It generally happens due to severe hormonal imbalances. 

Causes of irregular periods can be divided into lifestyle factors and medical factors.

Lifestyle factors

Stress: It may affect your hormones and the hypothalamus (the part of the brain that controls periods). Stress is the most common cause behind irregular periods, affecting every second woman.

Sudden weight loss or weight gain: Sudden changes in weight can change how the body functions and can stop ovulation.

Too much exercise: Exercise is good for health but too much of it can affect ovulation. Women who exercise a lot, or have increased the amount of exercise in a short span of time, may have irregular periods.

Working late shifts: Working evenings and late nights can affect the internal biological clock and affect periods.

Travel: Travelling to different time zones can affect a woman’s internal biological clock and most importantly her hormones. Her period will likely go back to normal when life goes back to normal routine.

Medical factors

Pregnancy: A late period is often an early sign of pregnancy. 

Polycystic Ovarian Syndrome (PCOS): PCOS upsets the hormone levels. In PCOS, small cysts form in the ovaries that lead to irregular ovulation or can stop it completely. Other symptoms include excessive facial hair or on other body parts, acne, hair fall, etc.

Early menopause: Menopause usually begins between 45 and 55 years. If a woman starts experiencing symptoms by 40, it is can be called early menopause. Symptoms include missed or irregular periods.

Thyroid issues: An overactive or under-active thyroid can cause late, missed or irregular periods. As the thyroid gland controls the metabolism, hormone levels are affected causing irregular periods.

Endometriosis: Endometriosis can also cause irregular periods. It is a painful disorder in which tissue that normally lines the inside of the uterus, the endometrium, grows outside the uterus.

Birth control pills: Most of the birth control pills contain a combination of the hormones, estrogen and progesterone. These pills prevent ovaries from releasing the eggs to prevent pregnancy. Going off or on birth control pills can affect menstruation cycle. Many women report having irregular or missed periods for up to six months after discontinuing birth control pills.

Symptoms

• If you have missed two or more periods in a row.
• If your menstrual flow is much lighter or heavier than usual.
• If your periods last longer than seven days
• If your periods are accompanied by pain, cramps, nausea, or vomiting
• If you experience bleeding or spotting between periods, after menopause or after intercourse.
• If you only have three or four periods a year, or if you continue to have irregular periods, visit your doctor for a complete checkup.

Possible treatments

Treatment depends on the cause. Usually lifestyle changes and some healthy preventive measures can help. The doctor may suggest medicines when irregularity is related to some medical problem.

Some helping measures 

Yoga: If stress is the cause, practising yoga is the best solution. Doing yoga for at least half an hour a day, six times a week may help regulate hormones and menstrual cycle.

Maintain a healthy weight: Being overweight or underweight can cause irregular periods. Maintain a healthy weight so that your biological clock can work properly.

Exercise regularly: Moderate exercise can help control weight that may help in regulating menstrual cycle. It may also reduce the pain before and during the period.

Get daily dose of vitamins: Low levels of vitamin D may increase the risk of irregular periods. Taking vitamin D supplements helps regulate your cycle. Vitamin B may also help in reducing PMS and regulate menstrual cycles. Many anaemic women also have irregular periods. So get your haemoglobin tested and take iron supplements, it levels are low.

— The writer is gynaecologist, Indira IVF Hospital, Chandigarh