If you experience any of the above mentioned symptoms, do get yourself medically reviewed as soon as possible.
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Menstrual problems or irregular menses can affect many women of the reproductive age group.
This includes problems such as irregular periods, missed periods, heavy menstrual bleeding, abnormal uterine bleeding,abnormal spotting between periods or prolonged periods.
What is an Irregular Period?
The average menstrual cycle length of a woman with regular menstrual periods usually ranges anywhere from as short as 21 days, to up to 35 day cycles. An irregular menstrual cycle is one that has an abnormal menstrual flow, pattern or timing.
Having regular periods and a normal cycle does not necessarily mean your menstrual cycles have to come at the exact same time of the month like clockwork. In fact, very few women have such menstrual regularity.
But it is important to ensure that you get at least three or more periods in a year. Meaning, your period comes at the minimum, once every 3 months. This is important to maintain a healthy female reproductive system.
Irregular menstrual cycles also include delays in your period, irregular or missed periods, vaginal spotting, heavy bleeding or bleeding when you are not supposed to.
An irregular menstrual cycle may either be present since menarche (first onset of a girl’s period), or it may be a new problem that develops in somebody with previously normal menstrual cycle
If you experience any of these symptoms, you should definitely seek medical attention and be further evaluated by your women's health doctor.
Causes
There are many factors that cause irregular periods, and the exact cause can only be determined after you have had your doctor’s consultation and a detailed history, physical examination and relevant investigations have been carried out.
Some of the causes of irregular periods include:
- Female Hormone imbalances
- Extreme weight loss due to eating disorders
- Extreme exercise
- Pregnancy
- Early pregnancy loss
- Polycystic ovary syndrome (PCOS)
- Underlying medical conditions such as Pituitary disorders (tumours) or thyroid dysfunction
- Overweight
- Certain medications
- Problems with the reproductive tract eg pelvic inflammatory disease, uterine fibroids or endometriosis
- Stress hormones and other irregular lifestyle factors
Symptoms
Important irregular period symptoms to look out for include symptoms that are associated with the irregular cycle pattern, or any following symptoms that may be associated with underlying disease.
Some irregular period symptoms that are a sign of abnormal periods include:
- Delayed period
- Missed period
- Abnormal vaginal bleeding or spotting
- Bleeding when you are not supposed to
- Prolonged menstrual cycles
- Irregular bleeding
- Heavier bleeding
- Menstrual cramps
Other symptoms that could signify underlying disease that can affect menstruation include:
- Severely overweight
- Severely underweight could indicate an underlying eating disorder
- Fast heartbeat, sweating excessively or a growth in the neck for possible thyroid disease
- Excessive hair growth and acne for underlying polycystic ovarian syndrome
- Visual disturbances or headaches could indicate an underlying pituitary tumour in the brain
Complications
Some young women may mistakenly think that it is normal to skip periods, or find it convenient and hence hold off seeing a doctor for their irregular periods. But it is extremely important to understand that menstrual irregularities should always be evaluated by an experienced medical professional.
Ignoring the warning signs of irregular menstruation could potentially lead to long term unwanted complications such as fertility issues, or an increased risk of womb cancer due to long term build up of the lining of the uterus.
Undiagnosed conditions like polycystic ovarian syndrome can also lead to long term complications like metabolic syndrome – obesity, high cholesterol and diabetes. It may also increase the risk of fertility problems and womb cancer.
Irregular periods medically reviewed by an experienced women’s health doctor is definitely a must.
Treatment
Irregular periods treatment depends on the underlying causes of irregular periods.
The first important step before treating irregular periods is to have a thorough medical history taken and physical examination, followed by the relevant investigations to look for the underlying reason.
Blood tests are a simple way of checking for hormonal imbalance and other reasons for your irregular periods. You will also be required to do a PAP smear if you do not have a recent one, and a pelvic ultrasound to check for any underlying abnormalities that can affect your menstrual period.
Lifestyle factors go a long way in helping to regulate periods. You are encouraged to lose weight if you are overweight, and to have a balanced diet with regular exercise. These simple lifestyle changes can actually improve the irregular periods effectively, and some women can achieve a normal menstrual cycle without medication.
A vast majority of women with irregular periods may require some medications such as hormone treatments to help improve their menstrual cycle. Hormonal medications like oral contraceptive pills or birth control pills are commonly prescribed.
Birth control pills contain hormones estrogen and progesterone. They are useful in helping a woman achieve regular periods, provide birth control and reduce heavy bleeding and pain.
Pregnancy
Irregular periods should all the more be medically reviewed if you are trying to conceive and start a family. Many women only decide to seek help for their irregular periods when they realize they have trouble conceiving.
It is important not to have any unnecessary delays as it could affect your fertility.
Many women with irregular menstrual cycles have problems with ovulation, which is why they may find it more difficult to conceive.
Some simple tips include:
seeing a doctor early to get evaluated
maintaining a healthy weight and healthy lifestyle
moderate weight loss is encouraged if you are overweight
have regular sexual intercourse at least 3 times a week
When to See a Doctor
You should see a doctor early if you experience any of the following symptoms:
- Delayed period
- Missed period
- Abnormal vaginal bleeding or spotting
- Bleeding when you are not supposed to
- Prolonged menstrual cycles
- Irregular bleeding
- Heavy bleeding
- Menstrual cramps
- Painful periods
- Severely overweight
- Severely underweight could indicate an underlying eating disorder
- Fast heartbeat, sweating excessively or a growth in the neck for possible thyroid disease
- Excessive hair growth and acne for underlying polycystic ovarian syndrome
- Visual disturbances or headaches could indicate an underlying pituitary tumour in the brain
If you experience any of the above mentioned symptoms, do get yourself medically reviewed as soon as possible.
Frequently Asked Questions
Is it normal to have irregular periods?
Sometimes, some irregularities in the menstrual cycle may be considered physiological (or normal) especially if a girl has just entered menarche, or if a woman is approaching menopause.
However, this can only be diagnosed after further investigations are done to rule out other abnormal causes.
It is also normal for you not to get your period at the same time every month like clock work, but your periods should at least come once every 3 months. If you experience any delay, missed periods or irregular cycles, it is best to consult a doctor for further evaluation.
When should I be concerned about irregular periods?
You should be concerned if you experience any change in the cycle pattern, flow or timing of your menstrual cycle from your normal pattern. It is best advised to be further worked up by your doctor.
This is especially important if you are above 35 years old, if you are experiencing any other additional symptoms, or if your menstrual cycle has been very irregular since menarche.
Do irregular periods mean PCOS?
No, not all irregular periods are caused by PCOS. There can be several other reasons for irregular periods such as hormonal abnormalities, pituitary brain tumour, medications etc.
Do get yourself checked if you are unsure.
How Do I Know If My Abnormal Bleeding Is Due to Cancer?
There can be many different causes of abnormal irregular bleeding ranging from benign causes like hormonal imbalance to cancer of the cervix or womb.
It is therefore important to have a recent of up to date PAP smear to check for any abnormal cervical cells.
Sometimes, an endometrial biopsy may also be required to rule out womb cancer.
Is there a way to bring back my regular menstrual cycle?
It all depends on the diagnosis you have. If the disorder is reversible, there is a higher chance for you to have a regular menstrual cycle again. Therefore it is important to see a doctor and get treatment early.
Services
MENSTRUAL HEALTH
FERTILITY
AUTHOR
Dr Michelle Chia
Medical Director
After graduating from the National University of Singapore, Dr Michelle's journey allowed her to train in Women's Health and Aesthetic Medicine. Her experience has led her to be featured on multiple media platforms including Radio Stations and prominent Magazines like Her World, Women's Weekly and CLEO. Her work has also received recognition both locally and internationally in several Medical Conferences.
Ezra Clinic is a Women’s Health, Wellness and Aesthetic Clinic that is conveniently located at the top floor of Royal Square Medical Suites in Novena, Singapore’s Medical Health Hub.
Helmed by Dr Michelle Chia, Ezra Clinic is your chosen one stop clinic for all your Women’s Health and Wellness needs.
Address
101 Irrawaddy Road #21-09, Royal Square Medical Centre, Singapore 329565