Menstrual Irregularities Should Be Taken Seriously

The menstrual cycle is a critical indicator of overall reproductive health in women. A regular menstrual cycle typically lasts between 21 and 35 days, continues for 2 to 7 days, and involves a specific amount of bleeding. However, this regularity may sometimes be disrupted, a condition referred to as "menstrual irregularity." As a specialist in Obstetrics and Gynecology, I emphasize the importance of understanding the underlying causes of menstrual irregularities, establishing an accurate diagnosis, and planning appropriate treatment. In this article, I will discuss the causes, diagnostic methods, and treatment processes for menstrual irregularities.

What Is Menstrual Irregularity?

Menstrual irregularity refers to deviations from the normal range of the menstrual cycle. It can be categorized as follows:

• Oligomenorrhea: A menstrual cycle lasting longer than 35 days.
• Polymenorrhea: A menstrual cycle lasting less than 21 days.
• Amenorrhea: Absence of menstruation for 3 months or longer.
  • Primary Amenorrhea: Absence of menstruation during adolescence.
  • Secondary Amenorrhea: Absence of menstruation for over 3 months in a woman who previously menstruated regularly.
• Metrorrhagia: Irregular bleeding outside the menstrual period.
• Menorrhagia: Prolonged or heavy menstrual bleeding.

Causes of Menstrual Irregularities

Menstrual irregularities may result from various factors, including:

1. Hormonal Imbalances: Disruptions in the hormonal system can affect menstrual regularity. Prominent hormonal causes include:

• Polycystic Ovary Syndrome (PCOS): Commonly leads to irregular periods due to ovulation disorders.
• Thyroid Disorders: Excessive or insufficient thyroid hormone production can disrupt menstrual cycles.
• Hyperprolactinemia: High levels of prolactin hormone can cause missed or irregular periods.
• Menopause or Premature Ovarian Failure: Hormonal fluctuations associated with these conditions may disrupt menstruation.

2. Stress and Psychological Factors: Stress can interfere with the hypothalamic-pituitary-ovarian axis, leading to menstrual cycle changes.

3. Eating Disorders and Significant Weight Changes

• Disorders like anorexia nervosa or bulimia can lead to hormonal imbalances.
• Extreme weight loss or obesity can significantly alter menstrual regularity.

4. Reproductive System Disorders

• Fibroids and Polyps: Benign growths in the uterus can lead to irregular bleeding.
• Endometriosis: The presence of uterine tissue outside the uterus can disrupt the menstrual cycle.

5. Medications and Medical Treatments: Contraceptives, blood thinners, and hormonal therapies may cause changes in the menstrual cycle.

6. Other Systemic Conditions: Chronic illnesses such as diabetes, chronic kidney disease, and certain infections can impact menstrual regularity.

Diagnostic Process

Identifying the underlying cause of menstrual irregularities requires a comprehensive evaluation, including:

1. Detailed Medical History

• Onset and progression of menstrual changes.
• Associated symptoms (pain, heavy bleeding, etc.).
• Current medications and lifestyle habits.

2. Physical Examination

Evaluation of the reproductive organs to check for any anatomical abnormalities.

3. Laboratory Tests

• Hormone level assessments (FSH, LH, Prolactin, TSH, etc.).
• Complete blood count and biochemical parameters.

4. Imaging Techniques

• Ultrasonography: Used to evaluate ovarian and uterine structures.
• MRI or HSG (Hysterosalpingography): Helps identify anatomical abnormalities.

Treatment Methods

The treatment of menstrual irregularities is tailored to the underlying cause. Common approaches include:

1. Hormonal Therapies

• Birth control pills are widely used to regulate hormonal imbalances.
• Hormone replacement therapy may benefit women with menopause or premature ovarian failure.

2. Lifestyle Changes

• A balanced diet and regular exercise help maintain hormonal balance.
• Stress management techniques such as yoga or meditation can be recommended.

3. Surgical Interventions

• Surgical treatment may be necessary for fibroids, polyps, or anatomical abnormalities.
• Laparoscopic interventions can be used in cases of endometriosis.

4. Medical Treatments

• Medications for thyroid disorders or to lower prolactin levels may be prescribed.
• Painful menstrual irregularities can be managed with analgesics and anti-inflammatory drugs.

Conclusion and Recommendations

Menstrual irregularities can significantly affect a woman's quality of life. However, with accurate diagnosis and appropriate treatment approaches, these problems can be effectively managed. As an Obstetrics and Gynecology Specialist, I emphasize that women experiencing menstrual irregularities should not ignore these issues and should seek professional support.

Early diagnosis plays a key role in preventing serious complications. Each woman's menstrual cycle is unique, and any noticeable change warrants medical consultation to ensure a healthy life.

Assoc. Prof. Dr. Pervin Karlı
Obstetrics and Gynecology Specialist