Menstruation is a cycle starts from one lunar month at puberty to the whole reproductive period till menopause. It is a cyclical process that occurs every month. Every month, the lining of uterus prepares under the action of female hormones which sheds at the end of the cycle called menstruation as bleeding from the vagina. The normal length of the menstrual cycle is 28 + 2days, varies in every individual woman. The bleeding may last from 2 to 7 days.
Irregular menstruation is when the normal menstrual cycle lengthens to more than 35 days or more. During a regular cycle, the time of ovulation and shedding of lining is predictable. This prediction helps women trying to conceive.
Irregular periods are also called oligomenorrhea. The irregularity can result due to a change in the contraception method, mainly because of hormone imbalance, endurance exercises or around the time of the menopause. Irregular periods can also be noticed during menarche. During menarche, it may take up to 2 years for a regular cycle to establish. However, if the irregularity of periods persists it should be medically supervised. Irregular menstruation not only includes the variability of time but also the considerably changing patterns of the amount of bloodshed during or in between the period presence of clots larger than 2,5 centimeter in diameter. The main symptom is when the cycles are longer lasts for 35 days or more.
Many things are responsible for irregular menstruation. Estrogen and progesterone keep the normal menstrual cycle in check. An imbalance in the secretion of theses hormones disrupts the otherwise normal menstrual cycle and disturbs the bleeding patterns. This is the only reason why the women during menarche and menopause have an irregular cycle.
Apart from hormone imbalance, other common causes of irregular menstruation include:
Polycystic ovarian syndrome (PCOS): Ovulation is absent or difficult in females suffering from PCOS. It is a condition in which there are several small, fluid-filled sacs called cysts to develop inside the ovaries. Because the egg is not released every month from the ovaries, ovary no longer secretes the hormones estrogen and progesterone to regulate menstruation. The levels of the male hormone, androgen, or testosterone are higher in women suffering from PCOS. Insulin plays a major role in disturbing the ovulatory cycle by the production of more testosterone in women suffering from PCOS. Studies show almost 10 to 20 % of women of reproductive age group are affected with PCOS.
Symptoms include obesity, acne, irregular or no periods, and excess hair growth.
Irregular menstruation can sometimes lead to serious health issues that further lead to conception and fertility problems.
Diagnosis: if any aspect of a regular menstrual cycle is disturbed the following lab tests are ordered to confirm the diagnosis after performing a thorough physical examination.
Blood test including a pregnancy test is performed to rule out pregnancy, hormonal levels (TSH, cortisol, prolactin, FSH, DHEA, 17-hydroxyprogesterone) and infection.
Ultrasonography, X-ray, Pap smear, Biopsy
Treatment solely depends on the cause of irregularity in menstruation.
No treatment is required during puberty and menopause, as irregular menstruation is only due to adjustment of the body to the transformation of life and reproductive organs.
A low-dose birth control pill decreases androgen production. It is made up of a combination of estrogen and progesterone may help. This will help to correct abnormal bleeding.
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