Are your monthly periods irregular? (Irregular Periods) - Let's find out exactly what this is!

A problem that many women and young girls often face is that their monthly periods are irregular. Some months they come earlier than expected, some months they are a few days late. Sometimes they don't come for two or three months in a row. Is this really normal? Or should we be worried about this? What are the reasons behind this? Let's talk about all this today.

What exactly is "irregular menstruation"?

To understand this better, let's first look at what a "normal" menstrual cycle is. On average, a healthy woman's menstrual cycle lasts about 28 days. But this is not the same for everyone. We consider a menstrual cycle that lasts anywhere from 21 to 35 days to be normal. On average, menstruation lasts from about 4 or 5 days to 7 days.

But if it deviates from this pattern, we call it irregular menstruation. Simply put, there are several situations in which your period can be "irregular."

But remember, your menstrual cycle doesn't have to be exactly the same every month, just like the one marked on the calendar. It's normal for there to be slight variations.

Conditions that may be associated with irregular menstruation

In medicine, we divide these irregular periods into several types.

• Amenorrhea: This is when your periods stop completely. If your periods stop for 90 days or more (unless you are pregnant, breastfeeding, or have gone through menopause), it is abnormal. It can also be a condition where you haven't started your period by the age of 15 or 16.
• Oligomenorrhea: This is when menstruation occurs very infrequently, meaning it occurs more than 35 days late, perhaps only 6-8 times a year.
• Dysmenorrhea : This is the medical term for severe abdominal pain. While mild abdominal pain and discomfort are common during menstruation, severe pain that is unbearable is not normal.
• Abnormal Uterine Bleeding: This includes bleeding between periods, heavy bleeding, or bleeding that lasts for several days.

Why is this happening? What are the reasons?

There are many reasons why irregular periods can occur, from simple stress to serious medical conditions. Let's take a look at some of them.

Medical Conditions

• Endometriosis :This is when the tissue that lines the inside of the uterus (endometrial tissue) grows outside the uterus, for example on the ovaries or fallopian tubes. This can cause severe pain, cramping, and abnormal bleeding before and during menstruation.
• Pelvic Inflammatory Disease (PID): This is a bacterial infection that affects the female reproductive system. It can often be caused by an untreated sexually transmitted infection (STI). Symptoms include a foul-smelling vaginal discharge, irregular periods, and pelvic pain.
• Polycystic Ovary Syndrome (PCOS): This is a very common condition these days. In this condition, your ovaries produce too much of the male hormone androgen. This can cause ovulation to be delayed or absent. It can make your periods irregular or stop altogether.
• Primary Ovarian Insufficiency: This is a condition in which the ovaries do not function properly in women under the age of 40. It can also be caused by things like chemotherapy for cancer.
• Thyroid problems: Underactive (hypothyroidism) or overactive ( hyperthyroidism ) thyroid gland can directly affect your hormonal balance and disrupt your menstrual cycle.
• Uterine or ovarian cancer: Some types of cancer can cause irregular periods and heavy bleeding.

Lifestyle Factors

Even changes in your daily life can affect your menstrual cycle.

• Stress : Excessive stress caused by things like an upcoming exam, problems at work, or problems at home can affect your hormones and disrupt your menstrual cycle.
• Body weight: Sudden significant weight gain or loss.
• Excessive exercise : People who exercise excessively to the point of having very low body fat levels (e.g., long-distance runners, dancers) may experience irregular periods.
• Other illnesses: Even a temporary illness like a common viral flu can cause your period to be late that month.

Other Causes

• Birth Control Pills : When you start taking these pills or stop using them, your periods may be irregular for a few months. This is normal until your body adjusts to the hormonal changes.
• Other medications:Certain medications, such as steroids or anticoagulants.
• Pregnancy complications: Due to miscarriage or ectopic pregnancy.
• Surgery: Surgery or blockages in the uterus, ovaries, or fallopian tubes.

How do you find this, Doctor?

If you notice any changes in your menstrual cycle, the best thing you can do is keep a diary of your periods. Write down the day your period starts, the day it ends, the amount of blood you bleed, whether you have any cramps, or if you bleed in between periods. This information will be very helpful to your doctor.

Your doctor will ask you about your menstrual cycle and medical history. He or she will then perform a physical exam and pelvic exam. In addition, they may also perform tests to determine the exact cause.

• Pelvic Ultrasound: This can check for uterine fibroids, polyps, or ovarian cysts.
• Endometrial Biopsy: A small sample of tissue is taken from the inner lining of the uterus and examined. This can detect endometriosis, hormonal imbalances, or cancer cells.
• Hysteroscopy: A procedure in which a small camera-equipped instrument is inserted through the vagina into the uterus to examine the inside.

How is it treated?

Treatment depends on the underlying cause of your irregular periods.

Treatment with Medications

Often, treatment begins with medication.

• Hormonal birth control: For irregular periods caused by conditions like PCOS and uterine fibroids, hormonal birth control pills, injections, or an IUD can help regulate your cycle.
• Painkillers: For minor aches and pains, you can take a painkiller like paracetamol or ibuprofen. However, if you have severe pain, you should definitely see a doctor.
• Hormone Therapy: This treatment can help with the irregularities that occur during perimenopause.
• Other specific medications: Medications such as tranexamic acid to control excessive bleeding or antibiotics may be given if there is an infection.

Surgical Treatments

These are usually only done if they cannot be controlled with medication or if the underlying cause requires surgery.

• Endometrial Ablation: A procedure that destroys the lining of the uterus to reduce heavy bleeding. However, this is only suitable for those who no longer wish to have children, as it makes it difficult to have children after this procedure.
• Myomectomy: Surgical removal of fibroids in the uterus.
• Hysterectomy: Surgery to remove the uterus in very severe cases that cannot be controlled by any other treatment.

What can we do to prevent irregular menstruation?

Although we cannot control some of the causes, we can reduce this risk by adjusting our lifestyle.

• Maintain a healthy lifestyle. Exercise regularly and eat nutritious foods. If you want to lose weight, don't go on a sudden diet, but lose weight gradually.
• Get enough rest. Sleep well.
• Manage stress. Try things like yoga and meditation.
• Avoid excessive exercise. Exercise at a level that your body can tolerate.
• Change sanitary pads every 4-6 hours. This can help prevent infections.

When should we definitely see a doctor?

If you have any of the following symptoms, definitely see your doctor as soon as possible.

Also, if you have even the slightest suspicion that you might be pregnant, be sure to see a doctor to confirm it.