Having irregular menstrual cycles can be linked to various causes, physiological, hormonal, lifestyle or medical problems.
A menstrual cycle is defined as regular if the rules are presented every 25 to 35 days. Below 25 days, the cycle is described as “short” (polymenorrhea). Beyond 35 days, it is described as “long” (oligomenorrhea).
Irregular periods at the beginning, during adolescence
The first irregular menstrual cycles may occur in the first years after menarche (first menstruation). “The adolescent’s reproductive system is still developing and may take time to establish a regular menstrual cycle”explains Dr. Franck Léonard, gynecologist at the Francheville Private Hospital in Périgueux (24).
Irregular periods during menopause
Women approaching menopause may experience hormonal fluctuations that lead to irregular menstrual cycles. The periods may vary depending on each woman: “They can not having a period for 2 months, and then have them every 15 days; or have normal cycles and sudden stop menstruation.”
Irregular periods because of the pill?
Using hormonal contraceptives, such as birth control pills, can also disrupt the menstrual cycle. It may take a few months for the body to adjust to the hormones. “It is important to remember that the regularity of taking a contraceptive pill is important, otherwise there is a risk of untimely bleeding. Some, such as microprogestins, must be taken at fixed time.”
Factors linked to lifestyle: stress, weight loss, etc.
Other factors may also come into play. For example, physical or emotional stress can influence hormone levels, particularly those involved in the menstrual cycle.
► periods of intense stress can disrupt the regularity of periods.
► Another cause: weight loss. “A variation of more than 10% in body weight can affect hormones and cause cycles to stop”continues the doctor.
► Theintense physical exercise and regular can also affect the menstrual cycle by influencing hormone levels. “This is often seen in elite athletes.”
► Eating disorders, such asanorexia or bulimia, can cause significant hormonal changes, affecting the regularity of periods.
► Finally, sudden changes in lifestyle habits, such as frequent travel or changes in sleep schedules (jet lag), can disrupt the menstrual cycle.
Less than 6 periods per year: PCOS?
Some chronic illnesses, like polycystic ovary syndrome (PCOS), can cause menstrual irregularities. “Polycystic ovary syndrome is a hormonal disorder that affects women of childbearing age, explains the specialist. It is characterized by enlarged ovaries containing small follicles, but these follicles often fail to release eggs regularly.” Which in particular leads to irregular cycles. “We speak of PCOS when patients have fewer than 6 menstrual episodes per year.” Diagnosis of PCOS is usually based on evaluation of symptoms, medical history, physical exams, and blood tests. It also be associated with other health problems such as obesity (type 2 diabetes), lipid disorders and hypertension arterial. “Treatment depends on the patient’s symptoms. It may include oral contraceptives to regulate cycles, medications to treat insulin resistance, lifestyle changes such as exercise, and dietary adjustments. We can also advise a weight loss of more than 5% of total body weight.” Furthermore, uterine polyps or fibroids can also contribute to menstrual irregularities. “In some cases, surgery may be necessary to treat them.”
What to do ? What treatments?
“The history (i.e. the information you provide to the doctor), a gynecological examination, a pelvic ultrasound, an analysis of blood hormonal levels, as well as possible additional examinations, make it possible to clarify the diagnosis and to offer you appropriate treatment” assures our interlocutor. For example, hormonal contraceptives such as birth control pills may be prescribed to regulate menstrual cycles. “This may be the case in particular for polycystic ovary syndrome (PCOS) or to regulate bleeding between periods. We can also offer a treatment based on natural progestin, non-contraceptive, which the patient will take during the second part of her cycle (from the 15th day)”. Treatment is not always obligatory. “If the patient copes well with her cycle irregularities and it does not disrupt her quality of life, we will not give her any treatment.” On the other hand, if thyroid problems are detected, appropriate treatment can be prescribed to restore hormonal balance.
“Iron and vitamin B may be important for menstrual health”
Lifestyle changes, such as managing stress, eating a balanced diet and engaging in regular physical activity, can sometimes help improve the regularity of menstrual cycles. “Certain nutrients, such as iron and B vitamins, may be important for menstrual health, concludes Dr. Leonard. Supplementation may be recommended in the event of deficiencies.” Finally, proper weight management can help restore regularity to menstrual cycles.
Thanks to Dr. Franck Léonard, Gynecologist at the Francheville Private Hospital in Périgueux (24)