Irregular menstrual cycles: Causes and treatment

Surprise! It’s an unexpected period! Or it’s an exhausting, heavy period. How about the longer-than-expected period that has no respect for your carefully timed beach weekend.
Dealing with a regular, healthy menstrual cycle is enough of a chore without having your system go haywire, disrupting your daily life and plans.

Fortunately, many of the common causes behind an irregular menstrual cycle can be easily and successfully diagnosed and treated. Stop letting an irregular period control your life.

An irregular menstrual cycle is one that falls outside of “regular” ranges for an unexpected reason. Periods that are too long, too heavy, or occur at too frequent or infrequent intervals can indicate reproductive health issues, including a hormonal imbalance. Besides being a huge inconvenience, ongoing irregular menstrual cycles can also impact short- and long-term health.

What defines an irregular cycle?

An irregular menstrual cycle is usually diagnosed when cycles over the course of six months consistently fall out of the "normal" range a woman typically experiences.

Some common irregularities include:

  • Infrequent or too frequent periods
  • Unpredictable periods
  • Cycles outside the scope of 24–38 days
  • Cycles that vary in length by more than 7–9 days
  • No period for 90 days if not the result of pregnancy, menopause or hormonal birth control

What causes irregular cycles?

Women can expect irregular cycles during and life events, including during the first few years after the beginning of menstruation, perimenopause, during the postpartum months following pregnancy, while breastfeeding or after experiencing a miscarriage, even an early miscarriage that may appear to be a late period.

Polycystic ovary syndrome (PCOS) is a common culprit behind irregular menstrual cycles.

PCOS is a common hormonal endocrine disorder that affects up to 20 percent of women in their reproductive years. The disorder causes cysts to develop on the ovaries. These cysts can scar ovaries and even burst, causing severe pain. PCOS disrupts hormone production which can lead to irregular menstrual cycles.

During other times, periods should follow a regular pattern. If a woman is experiencing irregular menstrual cycles and isn’t going through a reproductive life change, many medical conditions can be the cause including:

  • Endometriosis
  • Changes in hormonal birth control
  • Thyroid disorders (hypothyroidism, hyperthyroidism)
  • Diabetes
  • Pelvic, vaginal and uterine infections
  • Uterine polyps
  • Uterine fibroids
  • Abnormalities of the vagina or cervix
  • Cancer
  • Benign growths or tumors
  • Bleeding disorders

However, in many cases, it’s found that a variety of conditions can impact menstrual cycles throughout a woman’s lifetime.

  • Sleep disorders or varying sleep schedules (i.e., jet lag or working night shifts)
  • Rapid weight gain or loss
  • Chronic stress
  • A strenuous exercise routine
  • Substance use/abuse
  • Eating disorders
  • Medications, such as anti-inflammatories and blood thinners

Can an irregular menstrual cycle impact overall health?

Irregular menstrual cycles can both indicate and lead to a wide range of more severe health conditions. Menstrual health is related to heart health, metabolism, sleep, fertility and more.
If you are experiencing irregular menstrual cycles, it's important to discuss possible causes with your healthcare provider to prevent harming your overall health.

What are the treatments for irregular menstrual cycles?

The treatment for each woman's irregular cycle will depend on the factors behind the irregularity.
After taking your full health and menstrual history, your provider will ask about changes to your lifestyle, weight, hair growth and unexplained pain.

Saliva tests to check hormone levels can reveal hormonal imbalances which can point to issues such as PCOS. Hormones typically checked include testosterone, thyroid hormone, prolactin, and analyses of sugar metabolism.

Your provider may also perform a pelvic ultrasound of your ovaries and uterus to look for cysts, tumors, fibroids or other irregularities in the pelvic structures that could impact your menstrual cycle.

If PCOS is the cause of the irregular cycles, your urogynecologist may recommend regulating hormones with birth control pills. If cysts become large and painful, surgeons can draw the fluid out of the cysts to reduce pain and scarring and lower the likelihood of complications. If symptoms become chronic, there are surgical options such as ovarian drilling, oophorectomy (removal of the ovaries) or hysterectomy (removal of the uterus and ovaries).

If the cause of your irregular menstrual cycle is hormonal, your urogynecologist can recommend the appropriate hormonal therapy to bring you back into balance and regulate your periods. This can include something as simple as hormonal birth control pills or a long-term contraceptive intrauterine device (IUD). Hormonal therapy can also ease the symptoms of uterine fibroids endometriosis, including uterine tissue overgrowth and heavy bleeding.

In the most severe cases, in-office procedures such as NovaSure uterine ablation or surgery may be recommended for long-term relief of heavy and irregular periods.

Managing an irregular menstrual cycle is important to maintaining your health now and throughout your life.

If you are experiencing irregular periods, don’t just cope – take action! Schedule your appointment with the team at Coyle Institute today to find the causes of your irregular menstrual cycle and get you on the road to better reproductive and long-term health.