Irregular Periods

One of the leading causes in the United States for adolescent girls missing school is related to their periods. Ideally, a menstrual cycle should go 28 to 32 days with bleeding occurring for 4 to 7 days. However, many women of all ages experience irregularities in their cycle and one common cause for concern is amenorrhea (absence of a menstrual cycle or lack thereof). Just as many other medical disorders, there is either primary amenorrhea or secondary. Primary amenorrhea is classified in girls who have never had a menstrual cycle and secondary is due to another cause a woman no longer has a menstrual cycle. Some causes of amenorrhea include:

  • Sign of an underlying hormonal imbalance
  • PCOS
    • Polycystic ovarian syndrome
      • Hyperandrogenism → too many androgens (sex hormones in the body, i.e. high LH, testosterone)
      • Unwanted facial hair
      • Acne
      • Obesity
      • Diabetes mellitus
    • Stress
      • Unmanaged can lead the body to stop menstruating
      • The sympathetic nervous system produces the fight or flight response → adrenal glands release stress hormones, i.e. cortisol and adrenaline → prevent fertility hormones from being released correctly
    • Thyroid dysfunction
      • Overactive or underactive thyroid → fertility problems
    • Hypothalamic dysfunction
    • Pituitary failure
    • Gonadal failure (i.e. Kallmann)
    • Gonadal dysgenesis (Turner’s, Swyer’s)
    • Imperforate hymen
    • Vaginal atresia
    • Mullerian agenesis
    • Androgen insensitivity

Causes of menorrhagia include:

  • Anovulatory dysfunctional uterine bleeding
    • Bleeding which occurs in the absence of recognizable pelvic pathology, medical disease, or pregnancy
  • Immature hypothalamus-pituitary-ovary axis
  • Pregnancy
  • Sexually transmitted disease
  • Chronic illness
  • Blood dyscrasia
  • Trauma
  • Drugs
  • Neoplasms (cancers)

A healthy, regular cycle is characterized by:

  • 28 day cycle
  • Regular month by month, i.e. predictable
  • Bleeding lasts 4 to 7 days
  • Bright red blood
  • No clots
  • No spotting
  • Minimal cramping or pain.

If you live in Denver and are not experiencing any of the regular signs of menstruation, visit the Denver Holistic Center for more information. All in all, an irregular period is characterized as one of the following:

  • Amenorrhea and oligomenorrhea
    • Either very little bleeding or none
  • Dysmenorrhea
    • Painful menstruation
  • Menorrhagia
    • Excessive bleeding

Each and every woman is different, so it is hard to generalize a treatment or management plan. The first step should be to find the underlying cause to a woman’s irregular periods. If the cause is something environmental, i.e. a stressor or food, then some psychological intervention may be necessary or a change in diet. Women who have an endocrine disorder should seek an endocrinologist to be placed on the appropriate drug regimen, i.e. hormones, NSAIDs, minerals. And for those women who may be approaching menopause, they should be adequately informed about the process their body is undergoing. Having an irregular period is not something to worry about, but something that should be managed.

Additionally, if a woman is trying to conceive, irregular periods will decrease her likelihood of becoming pregnant. Before ruling out any other medical disease, an individual should get a medical check up to measure their hormonal balance. As mentioned, estrogen and progesterone are of the most important hormones for conception and maintenance of a female’s reproductive system. Keep in mind there are some medical conditions, that when left untreated will lead to irregular periods.