Common causes of irregular menstruation include disease, hormone imbalances, stress, and weight changes. It is important to be aware that the regular menstrual cycle can be quite variable; women may have between 11 and 15 periods a year, and some women naturally fall outside even this broad range. In the first few years after the onset of menarche, it often takes time for the hormones to get in balance, and irregular menstruation is very common. Patients who experience extreme cramping, very heavy bleeding, and other symptoms have a cause for concern, but the occasional out-of-synch period is not necessarily an indicator of a issue.
Many things can cause hormone imbalances, including the onset of puberty and the start of menopause. Younger and older women often have irregular periods as a result. In women of reproductive age, one of the most common reasons to have a hormone imbalance is pregnancy or breastfeeding. Missed periods can indicate the start of a pregnancy. Women who breastfeed their children may notice that they do not have menstrual periods while breastfeeding, although this is not the case for all women. Underlying disease can also be a cause of imbalanced hormones.
Diseases that can lead to irregular menstruation include polycystic ovary disease, endometrial hyperplasia, diabetes, and some cancers. If a patient is in treatment for a medical condition, she may want to discuss the impact it could have on her menstrual cycle. If irregular periods onset suddenly and are accompanied by other symptoms, this may be a sign of an emerging medical problem.
Stress, including emotional stress, travel, and physical stress from a heavy exercise regimen, can also cause irregular menstruation. Women may also menstruate irregularly when they gain or lose weight, especially if it happens rapidly. Nutrition can be a factor as well. Eating disorders like anorexia are often accompanied by irregular or absent periods because patients do not get sufficient nutrition and lose weight very quickly.
Patients who notice irregular menstruation can discuss them with a gynecologist. It is advisable to bring up any recent lifestyle changes and to provide a detailed history. The doctor can evaluate the patient for common risk factors and may run a few tests to check for obvious causes like an endocrine problem. Some women naturally have irregular periods, and if they become a problem, the doctor could recommend the use of hormone therapy to regulate menstruation. This can limit cramping and heavy bleeding and should make things more comfortable.