Irregular Periods: What Causes Them and How to Treat Them?

Contents:

• What are Irregular Periods? 
• What is the Reason for Irregular Periods? 
• How Does PCOS Cause Irregular Periods? 
• Irregular Period: Symptoms and Signs That You Need to Watch Out For 
• How do you Identify the Cause of Irregular Periods? 
• Can Irregular Periods be Treated? 
• Ways to Prevent Irregular Periods 
• When to See a Doctor? 
• Don’t Have Time To Read? 
• FAQs 

What are Irregular Periods?

Generally, the length of a menstrual cycle is about 28 days, but it can also vary between 21 days to 35 days. Menstrual cycles that are shorter than 21 days and longer than 35 days are called irregular periods.

What is the Reason for Irregular Periods?

Many factors can contribute to irregular periods. Changes in your body's hormone levels, especially oestrogen and progesterone, can disturb the normal pattern of your cycle. Other than pregnancy and breastfeeding, here are a few reasons for irregular periods in women of reproductive age:

1. Polycystic ovary syndrome (PCOS): It is a condition that causes hormonal imbalance in your body and is considered one of the major causes of irregular periods.
2. Premature ovarian insufficiency (POI): It is a condition where normal ovarian function is lost in women under the age of 40, which results in menopause-like symptoms. Normally, women reach menopause between the age of 45 to 50 years of age.
3. Thyroid disorder: Your thyroid gland plays a major role in controlling your metabolism, which, in turn, can affect your hormones and cause irregular periods if your thyroid is overactive or underactive.
4. Stress: Chronic stress can wreak havoc in your body by causing fluctuations in hormonal levels. It can also lead to sudden weight gain or weight loss, changes in sleep patterns, reduced frequency of exercise and unhealthy food choices, which can disrupt your hormonal balance and cause irregular periods.
5. Obesity: Excess body weight can lead to the production of high levels of oestrogen, which can affect your menstrual cycle. This may not only cause irregular periods but can also stop your periods.
6. Low body weight: If you lose too much weight, it may cause a drop in oestrogen levels, which can prevent the eggs from releasing from your ovaries, resulting in irregular periods.
7. Too much exercise: Intense exercise can cause irregular periods. This happens when your body burns more calories than you consume, which results in the shortage of energy required to produce an adequate amount of reproductive hormones to cause ovulation.
8. Nutritional deficiency: Your body needs sufficient nutrients to function normally. Studies suggest that vitamin D deficiency may cause irregular periods. Also, iron deficiency can cause anaemia, which can result in irregular periods.
9. Uncontrolled diabetes: Poorly managed diabetes in which the blood sugar level is higher than normal can disrupt your hormonal balance and cause irregular periods.

How Does PCOS Cause Irregular Periods?

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. In women with PCOS, their ovaries produce more than the normal amount of male hormones called androgens, which are usually present in a smaller amount in females. 

This hormonal imbalance causes difficulty in the release of eggs from the ovaries (ovulation), which causes irregular menstrual cycles.

Irregular Period: Symptoms and Signs That You Need to Watch Out For

If your menstrual cycle is disturbed, you may also experience some of the following:

• A sudden change in the menstrual cycle length (shorter than 21 days, longer than 35 days)
• Less than eight or fewer menstrual cycles per year
• Bleeding or spotting between your periods
• Getting your periods after you have reached menopause

How do you Identify the Cause of Irregular Periods?

If you have irregular periods, your doctor may perform the following tests to diagnose the cause:

1. Pregnancy test: As pregnancy can lead to a temporary halt in menstruation, this test can help confirm the reason for missed periods.
2. Blood test: Blood tests will help detect causes of irregular periods like anaemia, problems with blood clotting, and thyroid function.
3. Vaginal cultures: This test is to look for infections of the reproductive system, which can sometimes cause spotting or bleeding between cycles.
4. Pelvic ultrasound: Pelvic ultrasound will create images of your uterus, ovaries, and pelvis. This test can help diagnose PCOS and POI.
5. Endometrial biopsy: In this test, a small piece of uterine tissue is removed and examined to check for endometritis. 
6. Sonohysterogram: This test can help detect abnormal growth such as polyps or fibroids inside the uterus.

Can Irregular Periods be Treated?

Depending on the cause, yes. You can regulate your periods with proper treatment and a healthy lifestyle. Your doctor may prescribe medications to induce ovulation as an irregular period treatment.

Medications to Induce Ovulation

Irregular periods can be treated with medications that can help release eggs from the ovaries and help to induce periods. Tablets for irregular periods include metformin, clomiphene, and letrozole. Gonadotropins are given by injection to induce ovulation.

Hormonal Contraception

Hormonal contraceptives are available in the market in the form of hormonal birth control pills, hormonal implants, intrauterine devices, and vaginal contraceptive rings. It is important that you discuss this with your doctor and use the mode of contraception that suits you.

Birth control pills contain both oestrogen and progestin, which decreases androgen production and regulates oestrogen levels in the body.  Regulating your hormones can reduce the risk of endometrial cancer and can also help prepare your uterus for mensuration and regularise your periods. 

Frequent use and discontinuation of hormonal contraceptives can cause irregularity in menstruation. Problems in conception are one of the adverse effects of delayed periods. Hence, healthcare providers may not prescribe hormonal contraceptives as a long-term treatment for women who wish to conceive in the near future.

Insulin-Sensitising Medication

As most women with PCOS develop insulin resistance, metformin, a drug used to treat diabetes, is also used in the treatment of PCOS. It works by reducing insulin resistance, and the production of androgen in your ovaries. This can improve the function of your ovaries and aid you in getting your periods back to normal.

Ways to Prevent Irregular Periods

A healthy lifestyle is known to be the most effective approach to managing any health condition. This includes the medical conditions that cause irregular periods too. 

Lifestyle changes can be challenging, but when done right, they can help normalise the ebb and flow of your hormones and regularise your periods. These changes include:

Having a Healthy Diet 

A healthy, nutritious and balanced diet that is rich in fibre, protein, antioxidants, vitamins and minerals while controlling your carbohydrate intake is key to maintaining optimum health. A balanced diet that is filled with fresh fruits and vegetables, whole grains, healthy fats and lean protein can help you manage several conditions like PCOS, diabetes, obesity, nutritional deficiencies, etc. which can cause irregular periods.

Avoid foods that are high in empty calories, added sugars, starch and saturated or trans fats, as they can be harmful to your overall health and adversely affect your hormonal balance.

If you believe your diet may be the reason for your disturbed menstrual cycle, consult a gynaecologist and a nutritionist to develop a healthy eating plan.

Exercising Regularly

Exercise regularly for at least 30 minutes a day, 5 days a week. This can help manage your weight, improve insulin resistance in your body and help balance your hormones, which in turn can help to normalise your periods. 

Exercise also has several other benefits like improved heart health, lowered cholesterol and blood pressure, a boost in metabolism and energy, better mood, etc.

Managing Stress 

Stress can have an impact on your menstrual cycle. The stress hormones (cortisol) released during stressful situations can increase your blood sugar levels. If you have PCOS with insulin resistance this can increase the insulin levels and cause hormonal imbalance that can disrupt your periods.

Chronic stress can also lead to unhealthy coping mechanisms like binge eating, making unhealthy food choices, smoking, alcohol consumption, lack of exercise, disturbed sleep, etc. which can throw your hormones off balance and increase your risk for obesity, Type 2 Diabetes, etc., all of which can cause irregular periods.

Try relaxing activities like yoga, meditation, tai chi, practising a favourite hobby, spending time with your loved ones or pets, and sleeping for a minimum of seven hours a day. This can help relax your mind and calm your nervous system.

When to See a Doctor?

Missing a period sometimes is common and not a cause for alarm. However, if you are missing a period consistently, this could be a sign of an underlying health condition. Consult your doctor if:

• You have missed a period more than three times in a row.
• Your period date changes every month. If your period occurs within less than 21 days and takes more than 35 days.
• Your period lasts for more than a week.
• You bleed more than seven days in a row.
• You have more pain or bleed more than usual.