What is Menstrual Irregularity? Why Does It Happen?

by Abbas Jahangir · June 24, 2024

Vaginal bleeding that occurs in monthly cycles is defined as menstrual bleeding or menstruation. These bleedings, also known as menstruation or periods, occur as a result of the renewal of the woman’s reproductive system every month.

What is Menstrual Irregularity?

Women menstruate from the ages of 12-13 until they reach menopause in their 40s. Menstrual bleeding; It is the vaginal expulsion of the uterine tissue prepared for pregnancy, as a result of which the pregnancy does not develop due to the egg and sperm not being fertilized. Menstrual bleeding normally occurs every 21-35 days. It continues for 4-8 days. This process is expected to repeat regularly from adolescence to menopause. Menstruation does not occur during pregnancy and breastfeeding (at the beginning). Normally, the period between two menstruations should be between 21-35 days. Shortening or lengthening of this period or abnormal interruption of menstruation is called menstrual irregularity.

Oligomenorrhea (infrequent menstruation);It is the name given to the period between two menstruations being longer than 35 days.
Polymenorrhea (frequent menstruation);It is defined as the period between two periods being less than 21 days.
Hypermenorrhea;Menstrual periods are heavier than normal and clotted.
Amenorrhea (lack of menstruation);It is divided into two: primary (primary) and secondary (secondary) amenorrhea. Primary amenorrhea is when menstruation does not begin until the age of 15. Secondary amenorrhea is the cessation of menstruation for more than 6 months in a woman who previously had a menstrual period.

Menstrual irregularities can also be classified as “menorrhagia” and “menometrorrhagia” according to the amount of bleeding.

Menorrhagia;It is menstrual bleeding at regular intervals but lasting for a long time.
Menometrorrhagia;It is bleeding at irregular intervals, in large amounts and for a long time. Myomas and/or tumors developing in the uterus, intrauterine device use, and ovarian cysts are the most common causes of menometrorrhagia.

What Causes Menstrual Irregularity?

Causes of oligomenorrhea (infrequent menstruation):

Women using hormonal birth control methods may experience infrequent menstruation for 3-6 months from the beginning. In some women, menstruation may stop completely.
This condition can be observed in young women who do heavy exercise.
Oligomenorrhea may occur in women who have just entered puberty and are approaching menopause, due to fluctuations in hormone levels.
This condition may develop in women with eating disorders such as anorexia and bulimia.
Women with diseases related to hormonal irregularities such as diabetes and thyroid may have infrequent menstruation.

Causes of polymenorrhea (frequent menstruation):

Stress can disrupt the hormone balance in our body. Disruption of hormone balance can also lead to frequent menstruation.
Infections and sexually transmitted diseases can also cause polymenorrhea. In addition to menstrual irregularity; There may also be other symptoms such as vaginal discharge, itching, burning during urination.
The disease called endometriosis; It is a condition characterized by the presence of tissue in the ovaries or Fallopian tubes that would normally be found in the inner part of the uterus. Endometriosis patients experience painful and heavy menstrual periods. They may experience bleeding between menstrual periods.
Menopause means the complete end of menstrual cycles in women. Although it varies from woman to woman, it is generally seen towards the end of the 40s. It may cause menstrual irregularity due to changes in hormone levels in the body.
Increased activity of the pituitary gland, inadequate nutrition, and psychological disorders are among the causes of menstrual irregularity.

Causes of primary amenorrhea (lack of menstruation):

thyroid diseases,
Diseases that cause reproductive organs to fail to develop properly (such as Turner syndrome),
Premature ovarian failure,
Familial late onset of puberty,
Changes in hormone levels,
It can be considered as the bleeding not being able to come out because the hymen (hymen) is completely closed.

Causes of secondary amenorrhea:

Pregnancy,
thyroid diseases,
Situations where the prolactin hormone level in the blood is high, such as breastfeeding,
antidepressant drugs,
Premature ovarian failure,
Eating disorders such as anorexia, bulimia,
brain tumors,
chronic diseases,
Disorders such as PCOS (polycystic ovary syndrome) and Cushing’s disease.

As can be seen, ‘What causes menstrual irregularity?’ There are many answers to the question. Many different diseases can cause menstrual irregularities in many different ways. ‘Does having a cold cause menstrual irregularities?’ is one of the frequently encountered questions, but there are not enough studies on this subject. Keeping track of the menstrual days, duration and amount by the patient and taking notes will help the physician to find the cause.

What are the symptoms of menstrual irregularity?

Symptoms for oligomenorrhea; These can be counted as more than 35 days between menstrual periods, less than nine menstrual cycles per year, irregular menstrual intervals and lighter menstruation than normal.

Symptoms of polymenorrhea may vary depending on the underlying cause. Polymenorrhea caused by infection may cause symptoms such as fever, vaginal discharge and itching. In cases caused by endometriosis, many different symptoms may occur in the days before menstruation, such as cramps, painful menstrual periods (dysmenorrhea), pain during sexual intercourse, excessive menstrual bleeding, and pain during bowel movements. Before menopause, polymenorrhea may be accompanied by conditions such as hot flashes and vaginal dryness. If polymenorrhea is associated with eating disorders, rapid and excessive weight loss may be observed in patients.

Symptoms for amenorrhea vary depending on the conditions that cause menstrual cessation. For example, in women with polycystic ovary syndrome (PCOS), in addition to amenorrhea, various symptoms such as increased hair growth, insulin resistance, and weight gain are also observed.

Does Menstrual Irregularity Prevent Getting Pregnant?

Menstrual irregularity can occur due to many different reasons. Not every menstrual irregularity is an obstacle to getting pregnant. However, some diseases that cause irregularity may prevent pregnancy. It would be beneficial for women who experience irregular menstruation to consult a specialist doctor to have their check-ups and to receive appropriate treatment for the underlying cause.

What are the Harms of Menstrual Irregularity?

Menstrual irregularity may be accompanied by excessive bleeding and cause anemia. People with anemia; looks pale, gets tired easily, may have difficulty concentrating. In cases where menstrual irregularity is due to PCOS, metabolic syndromes such as diabetes may occur in the patient.

How to Examine Menstrual Irregularity? What Tests Are Requested?

In patients presenting with menstrual irregularity, patient history is of great importance. The patient; She is expected to answer questions such as how often she menstruates, how many days her period lasts, approximately how much bleeding is, how many pads she uses per day, whether she has pain during menstruation, how severe it is, and whether she is sexually active. In addition, the presence of symptoms such as fever, pain during sexual intercourse, vaginal discharge, and bleeding between menstrual periods may also be questioned.

Tests for possible causes are requested by the physician. Tests such as blood test, pregnancy test, hormone tests, Pap smear test are examples of these tests. Imaging techniques such as ultrasound and MRI can also be used to diagnose the underlying disease.

Physical examination begins with examining the general appearance of the patient. During gynecological examination, the cervix and vaginal walls can be examined with the help of a tool called a speculum. It is a method called bimanual examination, in which one or two fingers of the active hand are advanced through the vagina and the other hand is placed on the abdomen to examine the structure of the internal genital organs. Both methods can be used in physical examination for the suspected cause.

How to Treat Menstrual Irregularity?

Menstrual irregularity may not always be a serious problem that requires treatment. The basic treatment principle is to find the underlying cause and apply the treatment plan accordingly. Birth control pills are frequently used medical treatment methods for menstrual irregularity. However, such as advanced endometriosis, where medical treatment alone cannot provide success, surgery may also be required. Therefore, those who experience menstrual irregularities should not neglect to go to the nearest health institution and get checked.

What is Good for Menstrual Irregularity?

There are some easy-to-do practices that can be good for menstrual irregularities.

Doing yoga:There are some studies showing that yoga helps correct hormone levels that cause irregularities. In addition, yoga is effective in reducing menstrual pain and soothing mental states such as depression and anxiety during menstruation.
Being at a healthy weight:Being overweight or underweight can cause menstrual irregularities. You can reduce your risk of irregular menstruation by keeping your weight within a healthy range.
Exercise:Exercising regularly, with appropriate weight; It helps keep your menstrual cycle regular by helping you maintain your weight. It can also reduce pain during menstruation.
Consuming ginger:Although there are not enough studies on it, it is stated that ginger is good for menstrual irregularities.
Using cinnamon:It is effective in regulating menstruation and treating PCOS.
Taking vitamins:Taking the vitamins you need daily can regulate your menstrual period. Especially in vitamin D deficiency, menstrual irregularities may occur. Vitamin D can be synthesized in our body with the help of sunlight or can be obtained from foods such as milk and dairy products and grains.
Drinking apple cider vinegar:It has been observed that drinking 15 grams of apple juice every day is effective in patients with PCOS and menstrual irregularities.
Consuming pineapple:It may be good for menstrual irregularity. Thanks to some enzymes it contains, it can relieve symptoms such as headaches and cramps that occur before menstruation