Menstrual Irregularities

What are menstrual irregularities?

For most women, a normal menstrual cycle ranges from 21 to 35 days. However, 14% to 25% of women have irregular menstrual cycles, meaning the cycles are shorter or longer than normal; are heavier or lighter than normal; or are experiencing other problems such as abdominal cramps. Irregular cycles can be ovulatory, meaning that ovulation (release of the egg) occurs, or anovulatory, meaning ovulation does not occur.


The most common menstrual irregularities include:

  • Amenorrhea or absent menstrual periods. When a woman does not get her period by age 16, or when she stops getting her period for at least 3 months and is not pregnant.
  • Oligomenorrhea or infrequent menstrual periods: Periods that occur more than 35 days apart
  • Menorrhagia or heavy menstrual periods:  Also called excessive bleeding. Although anovulatory bleeding and menorrhagia are sometimes grouped together, they do not have the same cause and require different diagnostic testing.
  • Prolonged menstrual bleeding: Bleeding that exceeds 8 days in duration on a regular basis
  • Dysmenorrhea: Painful periods that may include severe menstrual cramps.


Additional menstrual irregularities include:

  • Polymenorrhea: Frequent menstrual periods occurring less than 21 days apart
  • Irregular menstrual periods with a cycle-to-cycle variation of more than 20 days
  • Shortened menstrual bleeding of less than 2 days in duration
  • Intermenstrual bleeding: Episodes of bleeding that occur between periods, also known as spotting4 


How do health care providers diagnose menstrual irregularities?

A health care provider diagnoses menstrual irregularities using a combination of the following:

  • Medical history
  • Physical examination
  • Blood tests
  • Ultrasound examination
  • Endometrial biopsy—a small sample of the uterus’s endometrial lining is taken to be examined under a microscope
  • Hysteroscopy—a diagnostic scope that allows a health care provider to examine the inside of the uterus, typically done as an outpatient procedure
  • Saline infusion sonohysterography—ultrasound imaging of the uterine cavity while it is filled with sterile saline solution
  • Transvaginal ultrasonography—ultrasound imaging of the pelvic organs, including the ovaries and uterus, using an ultrasound transducer that is inserted into the vagina


What are the common treatments for menstrual irregularities?

Treatments for menstrual irregularities often vary based on the type of irregularity and certain lifestyle factors, such as whether a woman is planning to get pregnant.

Mainstream treatment for all of these menstrual irregularities typically include the use of oral contraceptives, cyclic progestin or even surgery.

This means that potentially toxic and dangerous medications are being used to treat menstrual irregularities in young, and otherwise healthy women. These medications can potentially increase the risk of breast cancer and also shut down their own body’s production of natural hormones – which are so vital to their intrinsic health.


Risks of Treatment with Oral Contraceptives

Oral contraceptives Increased risk of breast cancer:

  • Increased risk by 210% when taking birth control before the age of 20,
  • Increased risk of 40% if started at young age and lasts over 12 years,
  • Recent oral contraceptive use within the prior year is associated with an increased risk of 50% relative to never or former OC use.


Risk of Treatment with Progestins

Progestin refers to a hormone that is synthetically produced and differs in structure from progesterone, which is made by the body. There are numerous synthetic progestins used in hormone therapy, in contrast to only one molecule referred to as progesterone.

The natural progesterone hormone has no toxic side effects. However, the progestins and progestogens are potentially highly toxic because of their altered molecular structure. A significant side effect seen with synthetic progestins has been an increase in the risk of developing breast cancer, as shown by clinical trials such as the Women’s Health Initiative, in which more breast cancer was seen in the group taking progestins.

  • An Increased Risk of Abortion and Congenital Abnormalities If Taken by Pregnant Women
  • Fluid Retention
  • Epilepsy
  • Migraine
  • Asthma
  • Cardiac and Renal Dysfunction
  • Depression
  • Breast Tenderness
  • Nausea
  • Insomnia
  • Cancer
  • A decrease in Progesterone Levels


Natural Alternative Treatment to Menstrual Irregularities

The menstrual cycle is a complex interaction between the reproductive system and the endocrine (hormone-producing glands) system. This interaction is dedicated to the maintenance of the productive function and an appropriate hormonal balance in women. Menstrual irregularity is a symptom of a problem lurking somewhere in the two systems (reproductive and endocrine). Thyroid disorders can also affect the menstrual cycle resulting in different types of irregularities.


Have your Thyroid Checked

The thyroid is a small butterfly-shaped gland, which rests in the lower neck. Its main function is to control your body's growth and metabolism. To control metabolism, your thyroid gland produces hormones (thyroxine [T4] and triiodothyronine [T3]). A properly functioning thyroid will produce the right amount of hormones required to keep your body functioning normally.

Both 'over' (hyperthyroidism) and 'under' (hypothyroidism) activity of the thyroid gland can also lead to menstrual irregularity. Thyroid hormone levels can affect the metabolism of female hormones and interfere with the regulation of ovarian function. Frequently, precocious puberty (early onset of menstruation) and delayed puberty (late onset of menstruation) can be due to a thyroid problem. Besides this, you may also notice that certain changes in your menstrual patterns like having more or less frequent periods, markedly heavier or lighter periods, or the total absence of periods, and all of these could be due to the abnormality in your thyroid function.

Thyroid disease is frequently responsible for irregularities of a woman's menstrual cycle. If you have hyperthyroidism, you are likely to have precocious puberty, delayed puberty, lighter periods, sporadic periods (infrequent periods), and amenorrhea (absent periods). On the contrary, if you have hypothyroidism, you are more prone to have menorrhagia (heavy periods), more frequent and longer periods, and dysmenorrhea (painful menstruation).

If you have hypothyroidism, your doctor will start you on thyroid replacement therapy. Make sure that you are getting the “optimum” treatment. This is because you can still continue to have menstrual problems, if your thyroid-stimulating hormone (hormone produced by the pituitary gland and regulates the level of thyroid hormones) level is not optimum, and you are not taking a drug, which is appropriate for you. This may mean that you may need both the inactive form of thyroid (thyroxine), combined with the active form of thyroid (Liothyronine).


Try Natural, Rhythmic, Hormone Replacement

Your doctor may also conduct a thorough hormonal assessment at different phases of your menstrual cycle. Thus, she will be able to check your estrogen, progesterone, follicle-stimulating hormone, and luteinizing hormone levels, among others for evaluating whether your hormonal cycle is normal. If you have marked variations in the hormonal levels, you may require hormone therapy or further assessment.

Many menstrual irregularities may be stemmed from an imbalance of estradiol and progesterone. A short-term trial of natural rhythmic restoration (replacing hormones the way your body makes them), may just be the kick start that your body needs to get all of its hormone receptors back in order. If your receptors are back in order, then your body’s own production of hormones should be able to get your menstrual cycle back in a more natural rhythm.