Irregular Periods Treatment

'Irregular menses is among the top 3 reasons for a woman to visit a gynecologist'.

Hey there!

This is Dr. Manu, Consultant Gynecologist in Chennai, and in this article, I am going to educate you on everything about abnormal periods and its treatment.

When is a woman said to have irregular periods?

The normal monthly menstrual bleeding occurs during the last 4 to 7 days of the monthly menstrual cycle. For most women, the menstrual cycle occurs every 28 days. However, the normal range can vary from 21 to 35 days. 

A patient is said to have irregular periods if it occurs less in less than 21 days or if it occurs more than 35 days, or if it occurs once in 60 or 90 days missing 2 or 3 periods in a row. Excess bleeding or very light bleeding are also signs of problems.

The presence of bleeding in between the normal periods and bleeding after menopause are also signs of abnormal menses

Irregular periods treatment can be done with a combination of medications or procedures (where absolutely necessary)

Given below are a few terminologies your gynecologist will use in the context of irregular periods

A. Oligomenorrhea: Is a clinical diagnosis made to a  patient when the monthly menses occurs very infrequently

B. Dysmenorrhoea: This condition refers to periods that are associated with severe pain and a sensation of cramping. Although, it is quite common for women to experience some discomfort during their monthly cycles

C. Amenorrhea: Here, the individual’s cycles have probably come to a full stop. The absence of cycles beyond 90 days or so is considered problematic (except in case she is pregnant or going through menopause).

Also, in cases, the women is about 15-16 years of age, and if the cycles have not begun, amenorrhea is to be considered. 

D. Abnormal or Dysfunctional Uterine Bleeding: This condition is diagnosed for all patients for whom the periods last for >7 days and is very heavy in general.

The presence of bleeding or spotting in between periods or presence of bleeding after menopause should also be classified as abnormal uterine bleeding

What causes irregular periods?

There are numerous and I mean numerous causes of irregular periods. Let’s go through them briefly below

1.Contraceptive Pill Use: Most oral contraceptive pills (OCPs) contain a combination of two hormones namely progestins and estrogen. OCP’s prevent the growth of the egg. Taking OCP’s on and off then can severely affect the regularity of the monthly menstrual cycles. Some women may suffer from irregular periods upto 3 months post the menstrual cycles. 

2. Uterine Fibroids and Polyps: Uterine polyps, are simple non cancer growths of tissue lining the uterus. They can cause heavy bleeding and pain during periods

3. PCOS: Also called as polycystic ovarian syndrome, these are the commonest cause of irregular periods worldwide. PCOS is associated with a host of clinical conditions like Diabetes, Infertility et cetera. Women with PCOS are characterized by irregular cycles, biochemical signs of a complete imbalance in hormones and hirsutism (excess hair on the face).

4. Endometriosis: Endometriosis is a clinical condition that is associated with abnormal bleeding, cramps, and severe pain during the menstrual cycles

5. Pelvic Inflammatory disease (PID): PID can occur due to a bacterial infection of the female reproductive system. PID can occur from sexual intercourse and then spread upwards to involve the tubes. Gynecologic procedures when done improperly can also lead to PID. Symptoms of PID include vaginal discharge, a foul odor, fever, nausea, vomiting, and diarrhea. 

6. Stress and Unhealthy Lifestyle habits: Excessive weight gain and undue stress can also lead to irregular periods. Excessive weight gain also predisposes women to develop PCOS. 

While there are numerous other causes of irregular periods, the aforementioned causes are the most common.

Investigating Irregular Periods

Your gynecologist will usually take an in-depth clinical history while diagnosing Irregular periods. Some common questions asked would be

1. How many pads do you change in a day?

2. When did the symptoms first start?

3. Are you passing large clots?

4. What are the start and end date of the periods?. Is there bleeding in-between the periods?

Your gynecologist will also do a pelvic exam and take a PAP smear too. Certain common tests that your gynecologist will give you are as below

A. Blood tests for Anemia

B. Vaginal swab and culture

C. Ultrasound Scan to look for uterine abnormalities or cysts

D. Endometrial Biopsy to diagnose hormonal imbalance or precancerous cells.

Now, let’s move on to the last section of the article

Irregular Periods Treatment

The treatment of irregular periods largely depends on the cause

Different treatment strategies include

1. Control of Pain

2. Bringing regularity to the menstrual cycle

3. Uterine fibroids removal either medically or surgically

4. Managing Endometriosis

5. The use of a 5-year intra-uterine contraceptive device called Mirena can also be equally effective where indicated. 

Prevention of irregular periods:

Some tips to prevent irregular periods include

A. Maintain a healthy lifestyle

B. Avoid smoking and alcohol

C. Keep your BMI within 25 (kg/meter squared)

D. Follow the recommended treatment guidelines as adviced by your gynecologist

I hope you enjoyed reading this article on irregular periods treatment. Please do share this article with all your loved ones!.

References:-

  1. Managing irregular periods – Cleveland Clinic
  2. Harlow SD, Campbell OM. Epidemiology of menstrual disorders in developing countries: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology: REVIEW. 2004 Jan;111(1):6-16.
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