Irregular menstruation: causes and treatments for not living with this disease

Irregular menstruation is a problem that is present in the lives of many women. Their cycles do not vary according to those of women who have a regular menstrual cycle, who menstruate between 21 and 35 days, as reported by gynecologist and obstetrician at Ellas Clinic, Dr. Cristiane Provatti. “Irregular menstruation can be defined as a significant variation from the usual menstrual pattern. The patient has a menstrual pattern that is not cyclic, that is, the patient does not know when she will menstruate and may have bleeding for less than 21 days or more than 35 days.”, says the doctor.

See below the main types of irregular menstruation, what can cause it and the forms of treatment that help to alleviate the variations in the menstrual cycle.

Types of menstrual irregularities

According to the gynecologist and obstetrician, a member of the medical team at the Instituto Paulista de Ginecologia e Obstetrícia (IPGO), Dr. Paula Araújo, menstrual irregularity can occur in the intervals between cycles or due to changes in the flow. Below are the main types of menstrual irregularities, listed by Dr. Paula and Dr. Christian:

Irregularities in cycle intervals

• Oligomenorrhea: when the interval between two periods is longer than 35 days.
• Polymenorrhea: when bleeding occurs for short periods, about 21 days or less.
• Amenorrhea: The woman has not had a period until 16 years of age or has not had a period for a period of three months.
• Metrorrhagia or uterine bleeding: acyclic and completely irregular bleeding.

Irregularities in menstrual flow

• Hypermenorrhea or menorrhagia: characterized by dark bleeding, more than 8 days and in abundant amounts, greater than 80 ml.
• Menometrorrhagia: there is intense and prolonged blood loss, both during and outside of the menstrual period.
• Hypomenorrhea: the amount of menstruation is less than what is considered normal (30 ml) and lasting less than 3 days.

The best way to identify the type of irregular menstruation is to see a specialist doctor and report to him the menstrual problems that you have been experiencing. Thus, the diagnosis will be accurate, determining the causes and possible treatments.

Main causes

• polyps
• Fibroids
• endometrial hypertrophy
• polycystic ovary syndrome
• hyperthyroidism
• Illnesses such as the flu, infections and other more serious illnesses
• Contraceptives used without medical supervision
• antidepressants
• blood pressure regulators
• Antiallergic
• Stress
• Excessive alcohol consumption
• Changes in body mass
• intense physical activity
• Extreme time changes

In addition to those mentioned, the causes can vary, so Dr. Cristiane leaves an alert. “When the gynecologist asks about all the habits of the patient, it is to know if there are any of these factors that worsen the condition of the woman.”

Irregular menstruation and pregnancy

Having an irregular menstrual cycle can affect a possible pregnancy in many ways. According to Dr. Paula, irregular menstruation is a sign that there are changes in the female body and that this should be investigated and treated. “Most of the time it is accompanied by anovulation and, with that, the chances of pregnancy are reduced. The same occurs when there is a uterine cause causing irregular bleeding. Uterine changes influence the implantation of the embryo and likewise decrease the success rates with pregnancy”, explains the gynecologist.

for Dr. Cristiane, irregular menstruation can interfere with spontaneous pregnancy. “As it is difficult to know when the fertile period is, the woman who does not use contraceptives runs the risk of becoming pregnant. However, for those who are planning to get pregnant, because there is this same difficulty in knowing the fertile period, it can take time to get pregnant”, she ponders.

The table should not be used as a contraceptive method. “Even for women with regular cycles, the schedule can fail, as many factors can interfere with ovulation. For patients with irregular cycles, it is very difficult to predict ovulation, so the number of days to avoid sexual intercourse will be huge”, explains Dr. Paula.

treatments

Both doctors say that treatments for those who have irregular periods depend on identifying the cause of the problem. Only after investigation and discovery of the reason for irregular menstruation will it be possible to propose an appropriate treatment. Below are some examples of possible treatments:

• Therapy and hormone replacement: done through combined pills or monotherapy.
• Surgeries: endometrial ablation, which is performed in cases of bleeding, myomectomies, removal of fibroids, polypectomy, removal of polyps, hysterectomy, removal of the uterus.
• Contraceptive: effective in a case of polycystic ovary syndrome.
• Medicines: active in the most varied causes of the problem.
• Lifestyle change: diet, physical activity, stress, etc.

Therefore, the best treatment for irregular menstruation is to see a gynecologist and identify the cause of the irregularity.

How to calculate the fertile period in irregular cycle?

Knowing the day you will menstruate, the day that you are fertile, the day that PMS can start is not an easy task when you have an irregular menstrual cycle. According to Dr. Paula, the table may not be the most reliable method. “The safest way is by performing serial ultrasounds, hormonal control with estradiol, progesterone and LH dosage and observing clinical signs of increased body temperature, vaginal mucus, ovulation pain.”

However, if you want to calculate your period, even if this is not the safest way to know your fertile period, just follow Dr. Christian. “It is necessary to start considering the last 6 months of cycles. We must select the smallest and largest cycle. Thus, the fertile period is when the woman is between the first day of the fertile period of the minor cycle and the last day of the fertile period of the major cycle. Of course, the fertile period will not last all these days, but as it is an irregular cycle, it is always good to be sure.”

Dr. Paula illustrated the count with an example to better understand.

Subtract 18 from the total days of the shortest cycle. This value will be the beginning of the fertile period.

Subtract 11 from the longest cycle’s total days. This value will be the end of the fertile period.

Assuming the longest menstrual cycle is 40 days and the shortest cycle is 23 days, we have:

Beginning of fertile period: 23-18 = 5th day.

End of fertile period: 40-11= 29th day.

In this example, the woman who does not want to become pregnant could not have intercourse from the 5th to the 29th of the month. Leaving very few safe days left, which doesn’t work.”

How to live with irregular menstruation

Living with irregular menstruation should not be something to be endured. “Women don’t have to live with this. For all causes there is a treatment and she should look for a specialist to treat it “, emphasizes Dr. Paula.

Seeing a doctor is the best way to live with irregular menstruation. “Never fail to follow up with your trusted gynecologist, as some causes of irregular menstruation are serious and must be treated, in addition to having a balanced diet and physical activity”, reinforces Dr. Christian.

A few days early or late is not something that is out of the ordinary. But, if you notice that your cycle does not normalize and every month there is some irregularity, look for a doctor and take the appropriate treatment. Having your period under control helps you have a more peaceful life without any frights, either because it comes at a time when you don’t expect it or to avoid unwanted pregnancies.

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.