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Irregular Periods Can be a Sign of These Health Issues logo 13-12-2021 ( News Desk)
Irregular Periods Can be a Sign of These Health Issues (Picture credit: Pexels) © Anjali Thakur | Lifestyle Staff Irregular Periods Can be a Sign of These Health Issues (Picture credit: Pexels)

Any female whose menstrual cycle is of less than 21 days, more than 35 days, or cycle length varies significantly from month to month has irregular periods. Regulation of periods are under the effect of estrogen, progesterone, follicle-stimulating hormone, luteinising hormone. Imbalance in any of these hormones will cause menstrual irregularity.

However, irregular periods can be sign of underlying disease which requires treatment.

Hormonal Dysfunction

  • Polycystic ovary syndrome (PCOS)

Irregular periods are most commonly seen in PCOS. PCOS may cause prolonged menstrual cycle or even amenorrhea.In this disease, ovaries produce high levels of male hormone i.e. testosterone, which causes hormonal imbalance leading to anovulation and therefore infertility. Other than that PCOS also causes acne, insulin resistance and obesity.

  • Hypogonadotropic Hypogonadism

It is a condition in which pituitary and ovaries produces less or no hormones which leads to either irregular periods, scanty flow or even complete amenorrhea. The underlying cause may be because of damage to pituitary gland or hypothalamus secondary to injury,tumor or radiation, rapid weight gain, rapid weight loss, genetic defects etc. The underlying disease needs to be treated for the correction of this state.

  • Thyroid disorders

Thyroid is an important hormone of the body for regulation of periods. High level of thyroid hormone causes shorter periods with decreased flow and low level causes prolonged periods with heavy flow. Imbalance of thyroid hormone can usually be treated with oral medicine.

  • Prolactin disorders

Hyperprolactinemia is a condition in which the levels of prolactin are higher than normal. It is caused by prolactinoma (benign tumor of pituitary), hypothyroidism, and even by certain medicines prescribed for hypertension, depression, pain. Prolactin is mainly responsible for secretion of breast milk but it also affects sex hormone. Hence higher levels of this hormone may cause prolong menstrual cycle, irregular menses, ovulatory dysfunction and infertility.

  • Uterine factors
  1. Uterine polyp or fibroid: Polyp are non-cancerous growth from lining of the uterus but, may often warrant treatment. They may present as irregular menses and infertility. During infertility treatment it is recommended to remove uterine polyp as it may cause implantation failure due to mechanical barrier and some chemical substances. Uterine fibroid are also non-cancerous growth from the muscle of the uterus and may or may not require treatment depending on its position and symptoms. They may also cause infertility, heavy menstrual bleeding or pain during periods. Fibroids of any size bulging into the cavity needs to be removed in cases of infertility as it may also cause implantation failure due to same reasons as uterine polyp.
  2. Adenomyosis: Adenomyosis is a condition in which the inner layer of the uterus (endometrium) starts to grow in the muscle of the uterus (myometrium) causing increased size of uterus, pain during menses, heavy bleeding and irregular periods. It can also affect the hormonal milieu causing infertility. This condition is usually treated with oral medicine and rarely requires operative intervention.
  3. Intrauterine adhesions: Intrauterine adhesions can be formed due to infections or by over-zealous curetting. Depending upon the intensity of adhesions they might cause scanty flow during menses, complete cessation of menses, recurrent abortions or infertility. The treatments is hysteroscopic adhesiolysis in which using a hysteroscope the adhesions are broken and shape the cavity tried to be restored.
  4. Endometriosis: In endometriosis endometrium grows outside the uterine cavity and may present as painful menses, heavy flow during menses, intermenstrual bleeding and prolonged periods. The endometrium may attach itself to fallopian tubes which causes them to adhere to adjacent organs and damage their functionality or it may attach to ovaries which results in depletion of ovarian reserve or may attach even to rectum or intestine causing painful defecation and abdominal cramps.
  5. Cervical and endometrial cancer: Both cervical and endometrial cancer may present as irregular periods, intermenstrual bleeding, postcoital bleeding or foul-smelling discharge.

Other than these, irregular menses may occur due to natural hormonal shifts during puberty and during peri menopausal period. Likewise, females who are underweight, overweight, or are under heavy stress may also suffer from irregular periods. It may also happen with women who are breast feeding, doing strenuous exercise or are on contraceptive pill. However, these factors are not of much concern and the irregularity is corrected once the underlying cause is corrected.

Although irregular periods are generally caused by benign conditions and are treatable. But it is also associated with malignant conditions. Also, it is a prime concern for women seeking conception as it is associated with ovulatory disorders, decreased ovarian reserve or dysfunction of fallopian tubes. Hence, it is important to pay attention to the signs for timely treatment.

(Authored by Dr. Ila Gupta, Senior IVF Consultant and Clinical Director at Ferticity Fertility Clinics)

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