The average menstrual cycle lasts 28 days. Our lives impact our hormones, and therefore our cycles—for example, stress can delay your period. Some variation is to be expected, but bigger fluctuations are reason to investigate.
Unless it’s a symptom of a more serious problem, having an irregular cycle doesn’t usually keep women from leading regular lives. There are some exceptions. Trying for a baby may be more difficult with an irregular cycle—if the ovaries do not regularly release mature eggs, it can be harder to conceive.
The menstrual cycle doesn’t have the predictability of clockwork. Variability is actually normal, especially for young girls during their first few years of menstruation. Many hormonal changes take place during puberty, so it shouldn’t be surprising that it takes some time for the menstrual cycle to settle into a rhythm.
Significant changes to an already established rhythm, however, may be cause for concern, as are abnormally long or short intervals between periods. A “normal” cycle is anywhere from 21 to 35 days long.
The duration and intensity of bleeding should also be taken into consideration. Periods shorter than 2 days, or longer than 7 days are considered irregular (the average is 3–5). How heavy your periods are will greatly depend on your genetics and lifestyle—10ml per period is normal, so is 100ml.
Amenorrhea is the absence of menstruation.
Menorrhagia is abnormally heavy or prolonged bleeding.
If you’re concerned, see your doctor. A number of conditions may become serious if left untreated—it’s recommended that you raise any concerns as soon as possible.
In most popular media, a late period can only mean one thing. Pregnancy. This is a real possibility that should be taken very seriously. However, there are plenty of other potential causes of varying severity that should be taken into consideration.
Psychological disorders and acute distress have a noticeable effect on the more sensitive bodily processes. During periods of stress, cortisol levels increase. Cortisol can interfere with the menstrual cycle as it lowers the estrogen and lutropin levels, and regular ovulation may not occur. The disruption may be more severe if existing conditions are combined with excessive consumption of coffee, tobacco, alcohol, or drugs.
If you’ve done shift work, you’ll know that an inconsistent sleep-wake cycle wreaks havoc on the body. Your circadian rhythm directly influences hormone production.
Eating disorders such as bulimia or anorexia are common causes of irregular menstruation in young women. Undernourishment encourages the body to cut off functions that aren’t necessary for your survival so it can conserve energy—this includes your reproductive functions. Being overweight can cause your body to produce excess amounts of estrogen, which can also disrupt your cycle.
Excessive exercise creates a mismatch between energy consumed and energy used, resulting in what’s called low energy availability. This has the same effect as undernourishment, as the body prioritises essential bodily functions and may cause your period to become lighter, irregular, or stop altogether.
Breastfeeding keeps certain hormone levels high, so the longer a woman nurses, the longer she will experience a light period, or no period at all (although there is a great deal of variation, depending on the woman). When she stops breastfeeding, her period returns.
Hormonal contraceptives can reduce menstrual flow or stop it altogether.
Some neuroleptics and antihistamines block the onset of menstruation by increasing the level of prolactin. Too much prolactin in the blood causes hyperprolactinaemia, a condition that can lead to menstrual disturbances resulting from estrogen and testosterone deficiency. High levels of prolactin also can cause unwanted lactation and sexual problems.
Irregular periods in combination with increased body hair growth and acne may indicate polycystic ovary syndrome (PCOS, a.k.a.polycystic ovarian dystrophy). This is an endocrine pathology that has become quite common. It may be caused by increased exposure to endocrine disruptors—particular chemicals that mimic the function of hormones. EDs can be found in plastics, pesticides, pharmaceuticals, as well as food, water, and soil—pretty much everywhere.
Another common reason for irregular periods is hyperthyroidism. When levels of thyroid hormones are high, periods are shorter, farther apart, and may be very light. The opposite of this is hypothyroidism, which means thyroid hormones are in short supply—periods come closer together, menstrual bleeding is longer and heavier, and the woman has more cramps.
A hyperabundant menstrual period and pain in the lower abdomen can indicate polyps, fibroids, or cancer of the uterus or cervix. Menorrhagia can cause anaemia if left untreated.
Amenorrhea in combination with abnormal lactation may indicate prolactin adenoma (or prolactinoma), a benign tumor of the pituitary gland.
Endometriosis is a condition wherein uterine tissue grows outside the uterus. It is most likely to affect women during their childbearing years. This kind of cellular growth is not cancerous and may be asymptomatic, but it can be painful, and lead to other problems, including irregular periods, pain, and infertility.
Random menstruation or bleeding between periods can be due to pelvic inflammatory disease (PID). This is an infection of the female reproductive system that is much more common in women than in men. About 1 in 4 cases is caused by an STD.
Irregular menstruation combined with hot flashes, mood swings, and fatigue in an adult woman can be indicative of perimenopause or menopause transition, which lasts until menopause, when the ovaries stop releasing eggs. The average duration of perimenopause is 4 years, but can last up to 10.
Treatment of irregular periods depends entirely on the cause. Your doctor will ask you questions about relevant aspects of your life prior to diagnosis. Keeping track of your cycle, medication, diet, and exercise, and paying attention to how you feel under different circumstances can be helpful in this regard.
Not all doctors are 100% comfortable discussing feminine issues. If it so happens that you aren’t taken seriously or even dismissed entirely, find another professional. Do not let yourself go untreated because of someone else’s prejudice or incompetence. Your body deserves to be taken care of.
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