Is your period late too? Let's talk about oligomenorrhea!

Do you sometimes think, "Oh, why hasn't my period come yet?"? After waiting for days, and then sometimes in a month or two, it feels like a huge burden on your mind? Or for some people, their periods may come six or seven times a year. What is this really? Let's talk about this today.

What is Oligomenorrhea?

Simply put, oligomenorrhea is when your monthly period, or "period" as we all call it, is irregular and comes very infrequently. A healthy woman's menstrual cycle usually occurs every 28 days. However, anything between 21 and 35 days is considered normal. Menstruation can last anywhere from four to seven days. Most of the time, you will have the same number of days between your periods, sometimes even a day or two apart.

But in the case of oligomenorrhea, these periods are very irregular. You may not have a period for more than 35 days. Maybe instead of having a monthly period, you only have six or eight periods a year. Imagine how frustrating that is.

What is the difference between oligomenorrhea and amenorrhea?

These are actually two types of abnormal menstruation. Amenorrhea is when menstruation stops completely. That means either you never have a period, or you have had periods for months and then they stop.

But in oligomenorrhea , you have your period, but it doesn't happen on the scheduled days. Therefore, your period is lighter than normal. Do you understand the difference?

How common is this condition?

In fact , between 12% and 15.3% of women who menstruate will experience oligomenorrhea at some point in their lives. Between 10% and 20% of those who have difficulty conceiving have this condition. In particular, oligomenorrhea is very common with a condition called Polycystic Ovary Syndrome (PCOS) . Between 75% and 85% of those with PCOS have irregular periods.

What are the symptoms of Oligomenorrhea?

The main symptom is a late or absent period. However, depending on the cause, you may experience other symptoms. These include:

• Acne.
• Headaches.
• Hot flashes.
• Abdominal pain.
• Vaginal discharge.
• Impaired vision.
• Excess hair growth on the face and body.

Be careful if you have one or more of these.

Why are my monthly periods so irregular? What are the causes?

Most of the time, this is due to hormonal imbalances in your body. Your reproductive organs and glands in your brain produce different hormones to control your menstrual cycle. When these hormones are in balance, your menstrual cycle is very regular. But when hormones become unbalanced, it disrupts this regularity.

In addition, infections and structural abnormalities in your reproductive system can also disrupt your menstrual cycle.

Let's look at some of the main reasons:

Due to hormonal imbalances:

• Polycystic Ovary Syndrome (PCOS): PCOS causes your body to produce too many hormones called androgens (such as testosterone). This can interfere with ovulation, the process by which an egg is released from the ovaries.
• Androgen-secreting tumors: Some types of tumors that develop in your ovaries and adrenal glands can release androgen hormones and disrupt your menstrual cycle. These symptoms are similar to those of PCOS.
• Cushing's syndrome: In this condition, your body produces too much of the hormone cortisol. This can also cause hormonal imbalances and affect your menstrual cycle.
• Prolactinoma: This is a tumor that develops in the pituitary gland. This causes an excess of the hormone prolactin to be produced and a decrease in the sex hormones (e.g. estrogen) needed for normal menstruation.
• Primary Ovarian Insufficiency: In this condition, your ovaries stop producing eggs earlier than expected (before menopause). They also stop producing the hormone estrogen, which is needed for regular menstruation.
• Hyperthyroidism: If your thyroid gland is not functioning properly, the pituitary gland may produce too much prolactin and too little estrogen.
• Congenital Adrenal Hyperplasia: This is a condition that is present at birth. In this condition, the adrenal glands do not produce enough enzymes to make hormones needed for menstruation.

Infections and other problems in the uterus can cause:

• Pelvic Inflammatory Disease (PID): PID can be caused by untreated sexually transmitted infections (STIs). This infection and inflammation can disrupt your menstrual cycle.
• Asherman's syndrome / Endometrial adhesions: Scar tissue that forms in the uterus or cervix (often after a gynecological procedure such as a D&C - Dilation & Curettage) interferes with normal menstrual bleeding.

Other reasons:

• Diabetes Mellitus: Both type 1 and type 2 diabetes are associated with oligomenorrhea. It is more common in people who are underweight (more common in type 1 diabetes) and overweight (more common in type 2 diabetes).
• Eating disorders: Conditions like bulimia and anorexia can cause nutritional deficiencies and delay or stop menstruation.
• Extreme physical activity: When you put too much strain on your body through exercise, your body may not be able to properly perform important processes like menstruation.

Some medications can also affect:

• Hormonal contraceptives, like birth control pills.
• Antipsychotics.
• Antiepileptic drugs.

How does a doctor accurately diagnose this condition?

When you go to see a doctor, he or she will talk to you, run tests, and try to find out if you have oligomenorrhea and what the cause is.

Questions asked of you (Medical History):

Before you go to see your doctor, prepare a detailed history of your menstrual irregularities. Keep a record of things like the number of days between periods for at least two months. Your doctor will ask you questions like:

• What is your normal menstrual cycle like: how many days are there between periods, how much blood is lost, etc. Knowing your normal cycle will help your doctor understand the severity of the problem.
• Your family's medical history: If someone in your family has a condition that causes oligomenorrhea (e.g. PCOS), you are more likely to develop it too.
• Your habits and lifestyle: They will ask about your diet and exercise habits to see if they have any impact on this. They may also ask if you have unprotected sex to see if the problem is caused by an STI.
• The types of medications you use: Things like hormonal birth control pills, medications for mental illnesses, medications for epilepsy, and steroids can cause oligomenorrhea.

Exams:

• Physical Exam: Your face, neck, breasts, and abdomen will be examined to see if there are any symptoms that could be causing oligomenorrhea.
• Rectovaginal exam: The doctor inserts a gloved finger into the vagina and another finger into the rectum to check for any lumps or bumps inside the body. This can be a little uncomfortable, but it is important for diagnosis.
• Vaginal speculum exam: A device called a speculum is used to widen the vagina and cervix to check for bleeding, swelling, scar tissue, etc. A cervical swab may also be taken to check for infection.
• Abdominal exam: The abdomen is palpated to check for lumps, lumps, or areas that hurt when pressed.

Imaging tests that may be done include:

• CT scans: Can detect things like tumors that are causing bleeding.
• Pelvic and abdominal ultrasounds: Show signs of conditions like bloating and PCOS.
• MRI scan (Magnetic Resonance Imaging - MRI): Can confirm the presence of prolactinoma.

Blood Tests:

Blood tests can check your hormone levels and blood sugar levels. Your doctor may check hormone levels like these:

• Thyroid-Stimulating Hormone (TSH): If this is low, it may be a sign of hypothyroidism.
• Follicle-Stimulating Hormone (FSH): If this is high, it can cause Primary Ovarian Insufficiency.
• Luteinizing Hormone (LH): When compared with FSH, high LH levels can help diagnose PCOS.
• Prolactin: High prolactin levels may indicate a prolactinoma.
• 17-OHP: Congenital Adrenal Hyperplasia can be detected at this level.
• Blood sugar: The HbA1c test can detect diabetes.

Remember, not all of these tests are done for everyone. The tests you choose will depend on your symptoms and what your doctor thinks.

What are the treatments for this? (Treatment)

Oligomenorrhea is treated depending on the cause.

• Hormone therapy: If your oligomenorrhea is caused by a hormonal imbalance, your doctor may prescribe birth control pills or other hormone treatments.
• Surgery: If there are tumors that produce too much androgen, your doctor may recommend removing them surgically.
• Lifestyle changes: If this problem is caused by nutritional deficiencies or excessive physical activity, you will need to make changes to your diet and exercise routine.

Is there a way to prevent this? (Prevention)

There is no specific way to prevent oligomenorrhea. However, once the cause is identified, your doctor will recommend appropriate treatment.

What happens if you have oligomenorrhea? Should you be worried?

Oligomenorrhea itself is not a serious problem. However, it is important to find out what is causing it. This is because some underlying conditions can cause complications. For example, untreated PID and PCOS can lead to infertility. Also, if the uterine lining does not shed properly due to oligomenorrhea, there is a risk of developing conditions such as endometrial hyperplasia and endometrial cancer .

What time should I see a doctor?

If you have been missing your period for more than 35 days, or if you have been missing your period for months, you should definitely see a doctor. Late or missed periods are not normal. It is important to find the cause and prevent long-term complications.

Before you go to the doctor, record your period in a calendar or app. This will help your doctor answer questions about what is normal and what is abnormal. Many apps allow you to record things like:

• The exact days when menstruation begins and ends.
• How much blood is coming out (is it heavy, light, or normal?).
• Symptoms you experience before, during, and after your period.

What are the important questions to ask the doctor?

• "Should I be worried about my periods becoming irregular?"
• "Will my irregular periods affect my ability to have children?"
• "If I want to adopt a child, what treatment options do I have?"
• "Will I have to take hormone therapy long-term to control oligomenorrhea?"

Ask questions like these and clear your doubts.

Does Oligomenorrhea affect fertility? (Infertility)

Yes, oligomenorrhea can be a symptom of a condition that affects fertility, such as PCOS. Hormonal imbalances that cause irregular periods can also make it difficult for you to get pregnant.

Are PCOS and oligomenorrhea the same thing?

No. However, PCOS and infrequent periods often occur together. Oligomenorrhea can be a symptom of PCOS.

Finally, I have to tell you this...

If your period is irregular, don't panic. There are many reasons why your menstrual cycle could be irregular, most of which are harmless. However, if you have been missing your period for a long time, you should definitely see a doctor. Also, pay attention to other symptoms, such as how much bleeding you are having, whether you have abdominal pain, or unusual vaginal discharge. Share all of this information with your doctor. He or she will be able to pinpoint the cause of your irregular period and give you the treatment you need. Your health is very important to you, so it's important to pay attention to these things.

` Oligomenorrhea, monthly menstruation, late period, irregular menstruation, hormones, PCOS, women's health