What is Menstrual Irregularity?
In the female reproductive system, the uterine wall thickens every 28 days to prepare the uterus for pregnancy. This thickening is a layer rich in blood vessels. During periods when pregnancy does not occur, this layer is shed to regenerate. There is also some bleeding during this shedding. This bleeding is called menstruation or menses.
Women's menstrual periods vary between 21 and 35 days. Periods are calculated starting from the first day of menstruation. Bleeding that occurs outside this period is called menstrual irregularity.
What Causes Menstrual Irregularity?
There are many different reasons behind menstrual irregularities. Bleeding between cycles is called inter-cycle bleeding and is usually caused by a drop in hormones. A drop in hormone levels causes the uterus to lose hormone support. For this reason, bleeding in the form of spots is observed. Other factors that cause menstrual irregularity are as follows.
- Thickening of the inner wall of the uterus
- Lack of ovulation
- Ovulation-related problems
- Fibroids
- Polyp
- Cyst
- External hormone supplements
- Hormone disorders
- Infections
- Malignant masses in the uterus and ovaries
What are the Symptoms of Menstrual Irregularity?
The normally accepted menstrual cycle varies between 21 and 35 days. The duration of menstrual bleeding also varies between 2 and 7 days.
When women have menstrual cycles outside of these periods, it is called menstrual irregularity. This excludes women who have just started menstruating and women who are close to menopause. Apart from these, the symptoms of menstrual irregularity are as follows:
- Severe bleeding
- Anemia
- Pain or cramping
- Vomiting
- Constant fatigue
- Dizziness
What are Menstrual Irregularity Tests?
If menstrual irregularities are suspected, a detailed history is taken. Afterwards, patients undergo a gynecological examination. An ultrasound image is also taken during the examination. This imaging examines the uterus, ovaries and surrounding structures.
After the examination, some blood tests are requested to clarify the diagnosis. These include tests such as estrogen, FSH, LH, AMH. In some cases, sample tissue can also be taken.
The cause of menstrual irregularity needs to be understood so that treatment can be planned correctly. For this purpose, patients may need to have samples taken to determine whether there is thickening or a mass in the inner wall of the uterus.
What are the Treatment Methods for Menstrual Irregularity?
Menstrual irregularity is a symptom, not a disease. Because of this feature, it is possible to treat the underlying disease that causes menstrual irregularity.
Hormone Therapy
If menstrual irregularity is caused by hormone irregularity or deficiency, then hormone medications are used to regulate hormones. With the regulation of hormones, menstrual irregularity is also eliminated.
Organic Causes
When there is an organic condition such as polyps that cause menstrual irregularities, pathological tissues in the uterus are removed. In addition, although fibroids usually do not cause symptoms, in some patients they put pressure on the uterine wall and this can cause more bleeding. In these cases, fibroids must be removed.
Menstrual Irregularity during Puberty
There are different underlying causes of menstrual irregularity during adolescence. Among these, patients with excessive bleeding usually have clotting problems and are treated accordingly.
In addition, if menstruation occurs earlier or later than necessary during puberty, the causes should be identified and treated.
Menstrual Irregularity during Pregnancy
Since ovulation does not occur during pregnancy, women do not menstruate. It is normal for menstrual bleeding to start after childbirth. However, the onset of menstruation is related to breastfeeding.
Bleeding immediately after birth is not considered menstruation. This bleeding is lochia bleeding. The color of these bleeding, which is more than normal menstrual bleeding and lasts for 6 weeks, also changes over time.
Menstruation usually starts between 8 and 16 weeks. However, since breastfeeding changes hormones, there is a higher chance of no bleeding.
Women who breastfeed exclusively are not expected to menstruate in the first 6 months. Even if they menstruate, it is not expected to be regular. Sometimes mothers may not get their periods until their baby is 18 months old. Menstruation in mothers who have never breastfed ranges from 4 to 8. starts between weeks.
Menstrual irregularity during this period varies for many different reasons. If menstruation is less than 21 days and more than 35 days apart, menstrual irregularity is mentioned. Menstrual irregularities are often related to breastfeeding.
