The course of menstrual cycles is one of the important indicators of a woman’s health. It is worth knowing that irregularities that occur can be both temporary and signal more serious hormonal problems. What causes a cycle to become irregular? Is it always a cause for concern? In this article you will find the answers to these questions and learn how to diagnose and treat menstrual cycle disorders. Enjoy reading to better understand your body and take charge of your health.
What are irregular menstrual cycles?
We can speak of irregular cycles when the intervals between successive menstruations are variable or the periods are non-standard in terms of duration and abundance. Particular attention should be paid when:
● Cycles last less than 21 days or more than 35 days.
● Menstruation does not occur for several months (absence of menstruation, or amenorrhoea).
● You have very scanty (hypomenorrhoea) or heavy (menorrhagia) bleeding.
● You observe spotting between menstrual periods (e.g. mid-cycle).
Causes of irregular menstrual cycles
1. hormonal changes
Hormones that regulate the menstrual cycle, such as oestrogen and progesterone, play a key role in the functioning of the reproductive system. Disturbances in their levels can lead to irregularity. The most common causes are:
● Polycystic ovary syndrome (PCOS) – a condition characterised by excess androgens, irregular ovulation and cyst formation on the ovaries.
● Hypothyroidism or hyperthyroidism – thyroid dysfunction can affect the cycle by altering metabolism and hormone levels.
● Hyperprolactinaemia – quite rare clinically, elevated prolactin levels can be caused by pituitary tumours, among others
● Other endocrine disorders: phase II disorders, anovulation, premature extinction of ovarian function, low ovarian reserve.
2. Physical and health factors
● Stress – chronic stress affects the hypothalamic-pituitary system, which can inhibit ovulation.
● Sudden weight change – rapid weight gain or weight loss can disrupt the cycle.
● Intense exercise – excessive exercise, especially when combined with a calorie deficit, can lead to ovulation suppression.
● Chronic diseases – diabetes, coeliac disease or liver disease can affect the regularity of cycles.
3. transitional periods in a woman’s life
● Puberty – during puberty, irregularities are common before cycles become regular.
● Postpartum and lactation – menstrual cycles after childbirth, during the nursing period, may not occur or may be irregular at first.
● Peri-menopausal period – reduced ovulation before menopause leads to irregular cycles.
4. External factors and medication
● Hormonal contraception – introduction or discontinuation of birth control pills can affect menstrual cycles for some time. Also, taking them irregularly.
● Medications – some medications, such as steroids or antipsychotics, can disrupt your cycle.
Diagnosing irregular menstrual cycles
Diagnosis of irregular cycles begins with a detailed medical history and physical examination. It is important to determine whether the disorder is primary (present since the first menstruation) or secondary (occurred later). Key diagnostic steps include:
- History – to discuss menstrual history, lifestyle, stress levels and possible chronic diseases.
- Gynaecological examination – to assess the condition of the reproductive organs.
- Hormonal examination – to assess hormone levels (FSH, LH, AMH, oestrogen, progesterone, prolactin, TSH).
- Ultrasonography – identifies structural changes such as cysts or myomas.
- Additional tests – if necessary, tests for diabetes, thyroid disease, coeliac disease or other systemic conditions are performed.
Treatment of irregular menstrual cycles
Treatment depends on the cause of the disorder and may include:
1. lifestyle changes
● Maintaining a healthy body weight through a balanced diet and moderate physical activity.
● Stress reduction through relaxation techniques such as meditation or yoga.
2. pharmacotherapy
● Hormone replacement therapy – used for hormone deficiency.
● Hormonal contraception – helps to prevent inflammation in the ovaries during ovulation, regulate the cycle and reduce heavy bleeding. It can also give you the opportunity to avoid bleeding for several or even several months.
● Ovulation-stimulating drugs – e.g. for PCOS or when trying to get pregnant.
3. Causal, symptomatic and surgical treatment
● Treatment of underlying conditions such as thyroid disease or hyperprolactinaemia
● Assisted reproduction methods – in the case of trying to get pregnant, e.g. in vitro
● Surgical treatment for structural changes such as myomas or polyps.
Summary
Irregular menstrual cycles may only be a temporary disorder, but they can just as well signal serious health problems. It is therefore crucial to monitor your cycle and visit your gynaecologist regularly. Early recognition of the cause allows for effective treatment and an improved quality of life. Remember that reproductive health is an important part of overall well-being – it is worth taking care of at every stage of life.