Are your monthly periods irregular? (Irregular Periods) Let's talk about this!

A problem that many women, sisters, and daughters have is that their menstrual cycle doesn't come on time. Some months it comes early, some months it comes late. Sometimes it lasts for days, and other times there is heavy bleeding. You may also be wondering if this is normal or something to be worried about. So don't worry, we will talk about this in a simple and clear way today.

First, let's look at what a 'normal' menstrual cycle is.

When we talk about a 'normal' menstrual cycle, many people think that it should be exactly every 28 days. But that's not true for everyone. This can vary from person to person.

Simply put, a healthy woman's menstrual cycle is considered normal if it occurs between 21 and 35 days . That means if you have one period and it's 25 days before your next period, and then 30 days after that, it's not a big deal. Also, the number of days that your period lasts, that is, the number of days you bleed, is usually between 4 and 7 days .

So what does an 'irregular' period mean?

It's normal to have slight changes in your menstrual cycle. However, there are some changes that we should be a little concerned about. We call these conditions 'irregular menstruation'.

You can get a good idea about this from the table below.

Other conditions associated with irregularity

There are several medical terms associated with irregular menstruation. It's good to know a little about these as well.

• Amenorrhea: This is the complete cessation of menstruation. Unless you are pregnant, breastfeeding, or have gone through menopause, it is abnormal for your period to stop for 3 months or more. It can also be the case if you have not started menstruating by the age of 15 or 16.
• Oligomenorrhea: This is when menstruation occurs very infrequently. That is, it occurs less than once every 35 days, but about 6-8 times a year.
• Dysmenorrhea: This is the medical term for severe pain during menstruation. While mild cramps are normal, if the pain is unbearable and prevents you from performing your daily activities, you should be concerned.

Why does this happen? What are the causes of irregular menstruation?

There is not one single cause of irregular menstrual cycles, but many factors can contribute to them. These can range from simple stress to serious medical conditions.

Due to some medical conditions...

Some illnesses can cause our hormonal system to become unbalanced and cause irregular menstruation.

• Polycystic Ovary Syndrome (PCOS): This is a condition that is now seen in many young women. What happens here is that your ovaries produce too much of the male hormone called androgen. This can cause ovulation to be absent or delayed. So menstruation becomes irregular.
• Endometriosis: This is when the tissue that lines the inside of the uterus (endometrial tissue) grows outside the uterus, such as on the ovaries or fallopian tubes. This can cause severe pain and abnormal bleeding before and during menstruation.
• Pelvic Inflammatory Disease (PID): This is a bacterial infection that affects the reproductive system. It is often caused by untreated sexually transmitted infections (STIs). It can also cause symptoms such as irregular periods, heavy vaginal discharge, and lower abdominal pain.
• Thyroid Disorders: Underactive (hypothyroidism) or overactive (hyperthyroidism) thyroid gland can cause major hormonal changes. This directly affects the menstrual cycle.
• Cancer of the uterus or ovaries: Some cancers can also cause symptoms like irregular periods and heavy bleeding. Although this is rare, it is important to be aware.

Due to changes in our lifestyle...

Changes in our daily lives and habits also directly affect the menstrual cycle.

• Stress: Imagine you have an exam coming up, or a problem at work, or a family problem... When stress increases like this, our body's hormonal activity changes. Because of this, your menstrual cycle may be late, come early, or even not occur at all that month.
• Weight changes: Sudden weight gain or loss can also affect hormones. Especially in people who are very thin and have low body fat (e.g., long-distance runners, dancers), menstruation may stop.
• Excessive exercise: Moderate exercise is great. However, exercising too much or too hard can cause irregular menstrual cycles.
• Other illnesses: A temporary illness, like a common viral flu, can also cause your period to be late that month.

Other reasons...

• Birth Control Pills: When you start or stop using birth control pills, it takes a few months for your body's hormone levels to return to normal. During this time, your periods may become irregular.
• Other medications: Some medications, such as steroids and anticoagulants, can also cause changes in the menstrual cycle.
• Pregnancy-related complications: If a miscarriage or ectopic pregnancy has occurred, irregular bleeding may occur.

What can be done about this? How does a doctor detect this?

If you notice any changes in your menstrual cycle, the best thing you can do is keep a diary of your periods. Mark them on a calendar or in an app on your phone. Write down the day they started, the day they ended, how much blood you had (a lot or a little), and whether you had any cramps. This information will be very important when you go to see a doctor.

A doctor will examine you, ask about your menstrual cycle and medical history, and may also perform tests to determine the exact cause.

• Pelvic Ultrasound: This is like a scan of a baby in the womb. It can check your uterus and ovaries for any growths (fibroids, polyps, cysts) or other abnormalities.
• Endometrial Biopsy: This involves taking a very small piece of tissue from the inner wall of your uterus and examining it. Don't worry, this can accurately detect things like hormonal imbalances and endometriosis.
• Hysteroscopy: In this procedure, a small camera is inserted through the vagina into the uterus to observe the inside.

What is the treatment?

Treatment depends on the cause of your irregular periods.

Medications

Often, the first treatment is medication.

• Hormonal birth control: These are very effective for irregular periods caused by conditions like PCOS and uterine fibroids. They work by regulating your hormone levels and regulating your menstrual cycle. They come in the form of pills, injections, a vaginal ring, or an IUD.
• Tranexamic Acid: A medication used to control excessive bleeding.
• Painkillers: For minor pain, you can take a painkiller like paracetamol or ibuprofen. However, if the pain is severe, see a doctor for advice.
• Hormone Therapy: This treatment may be helpful for irregular periods that occur during perimenopause.
• Antibiotics: If the irregularity is caused by an infection, antibiotics will be prescribed.

Surgeries

In severe cases that cannot be controlled with medication, surgery may be necessary. This decision is made based on your age, medical condition, and whether you plan to have children in the future.

• Endometrial Ablation: A procedure to remove the lining of the uterus to control heavy bleeding. This is not suitable for those who are hoping to become pregnant in the future.
• Myomectomy: Removal of uterine fibroids.
• Hysterectomy: Complete removal of the uterus as a last resort in cases where the uterus has been severely damaged and cannot be cured by any other treatment.

What can we do to reduce this risk?

There are several things you can do to keep your menstrual cycle as regular as possible.

• Maintain a healthy lifestyle. Eat a balanced diet and exercise moderately.
• If you want to lose weight, do it gradually. Don't go on a drastic diet that restricts your food intake all at once.
• Give your body the rest it needs. Get enough sleep during the day.
• Reduce stress. Relax your mind by doing things like meditation, yoga, or engaging in a favorite hobby.
• Stay away from excessive, strenuous exercise.
• Change your pads or tampons every 4-6 hours. This can help prevent infections.
• Continue to see a gynecologist and your family doctor for regular checkups.

When should I see a doctor?

• If you experience unbearable, severe pain during or between your periods.
• Unusually heavy bleeding (wetting more than one pad in 2-3 hours) or passing large blood clots.
• If there is a foul-smelling discharge from the vagina.
• If menstruation lasts more than seven days .
• If you experience bleeding or brown discharge between periods or after menopause.
• If your normally regular menstrual cycle suddenly becomes very irregular .
• If you experience nausea or vomiting with your period.
• If you suspect you may be pregnant .

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