Irregular Periods (Missed Period)

Irregular periods are defined as the menstrual cycle that doesn’t follow the usual timeline of arriving every 21 to 35 days. That is, it may come too early, too late, or not at all. In some cases, even when it arrives on time, the bleeding may be too heavy, very light, or differ from one month to the next. This irregularity may arise from various biological or external factors and affect fertility and the natural flow of daily life.

Note that irregular periods a few times have nothing to worry about, and are quite normal and harmless. However, regular or constant changes in menstrual length and blood flow can signal an underlying issue, such as hormonal imbalances, stress, lifestyle changes, or other reproductive concerns.

What are the Types of Irregular Periods?

Irregular periods can manifest in different ways for each woman, depending on how the menstrual cycle deviates from its usual timeline, duration, and pattern. Some of the common types of period irregularity are:

• Oligomenorrhea: It is the type referred to as a delayed menstrual cycle, that is, of more than 35 days. Women with oligomenorrhea experience fewer than nine periods in a year.
   
• Amenorrhea: It is a condition with the complete absence of menstrual cycles for three months or longer. Amenorrhea is also common in pregnancy.
   
• Menorrhagia: Menorrhagia is defined as heavy or prolonged menstrual bleeding. In this type, women may pass large clots, experience disruption of their daily routine, or require multiple pads per day.
   
• Polymenorrhea: Polymenorrhea is the condition linked with early menstrual cycle, or periods every 21 days or less, meaning more than 12 times a year.

Each menstrual cycle type contributes to the development of a personalised treatment plan to achieve the best possible results.

What are the Causes of Irregular Periods?

Irregular periods can arise from various reasons that may directly or indirectly affect ovulation, which is the monthly release of an egg from the ovaries and determines the timing of periods. Some of the common causes of irregular periods may include:

• Hormonal Imbalance: Fluctuations in reproductive hormones, such as estrogen, progesterone, LH, and FSH, can disrupt the expected timing of periods.
   
• PCOS (Polycystic Ovary Syndrome): PCOS is a hormonal disorder in which androgen levels become elevated, affecting timely ovulation.
   
• Thyroid Disorders: Thyroid disorders, whether hypothyroidism or hyperthyroidism, can disrupt the body's metabolism and hormonal balance, leading to menstrual irregularity.
   
• Obesity and sudden weight loss: Having more than normal body fat can cause elevated estrogen levels; rapid fluctuations in weight may decrease estrogen levels, leading to absent menses.
   
• Eating Disorders: Low body fat percentage and insufficient hormone production may also cause you to have no period.
   
• Excessive Exercise: Extended periods of vigorous physical activity can lead to an irregular menstrual cycle; this is a direct result of decreased body fat and the associated hormonal imbalance.

Each cause helps identify the trigger of irregular periods and, eventually, helps choose the right treatment approach to restore normal ovarian function.

What are the Symptoms of Irregular Periods?

The symptoms of irregular periods are associated with visible changes in the menstrual cycle. These changes may include:

• The cycle stretches more than 35 days, or doesn’t arrive at all for a month or more.
   
• Periods arrive too frequently, essentially in less than every 21 days.
   
• Heavy bleeding lasting longer than it normally does, or including large blood clots.
   
• Light periods, meaning almost no bleeding or just light spotting instead of normal flow.
   
• Periods vary in timing, duration, and intensity of blood flow each month.
   
• Light bleeding or spotting that occurs in between periods or outside of your normal cycle.

Irregular periods can also make conception and making pregnancy a challenge, too, due to reduced fertility and unpredictable timings of ovulation.

How are Irregular Periods Diagnosed?

Irregular Periods diagnosis is a task in itself, as missed periods are often misinterpreted as occasional irregularity. This misinterpretation can lead to serious consequences in the form of reproductive complications. Therefore, a detailed assessment of menstrual cycles and overall reproductive health is essential, which can include the following tests and assessments:

Menstrual History Evaluation:

This is primarily a conversation phase of the overall assessment in which your doctor will begin with questions about your menstrual history, such as:

• How long does each cycle last?
   
• What is the duration of your menstrual cycle, meaning the number of days you bleed?
   
• How do you bleed, light, heavy, or unpredictable?
   
• Any other associated symptoms like pain, spotting, clots, and mood swings?

This phase is done to determine whether the irregularity is occasional or persistent.

Hormonal Blood Tests:

The next phase is the hormonal profile in your blood. This test checks for every hormone in your blood that may or may not be responsible for abnormal ovulation and menstrual irregularity. Hormonal blood profile includes the testing of the following hormones:

• Follicle-stimulating Hormone
   
• Luteinizing Hormone
   
• Prolactin levels
   
• Thyroid panel (TSH, T3, T4)
   
• Estrogen and Progesterone Levels
   
• Androgens

Pelvic Ultrasound:

A pelvic ultrasound is used to determine whether the irregularity is due to structural abnormalities in the ovaries or the uterus. These tests help visualise the internal structure of the reproductive organs and detect:

• Multiple small ovarian follicles or PCOS
   
• Fibroids
   
• Ovarian Cysts
   
• Endometrial thickness
   
• Blocked Fallopian tubes
   
• Other structural abnormalities of the uterus and ovaries

Apart from the visual representation of reproductive organs, these imaging tests also give insights into the physical causes of irregular periods, if any.

Endometrial Biopsy:

For most women who experience prolonged severe menstrual bleeding (heavy periods) lasting more than one year, an endometrial biopsy should be performed. During a biopsy, a small sample of the lining of the uterus will be taken and tested for:

• Endometrial hyperplasia
   
• Hormonal imbalance
   
• Precancerous changes

With irregular periods, an early diagnosis may dramatically increase your chances of becoming pregnant.

How are Irregular Periods Treated?

Since every woman’s menstrual cycle is different, the approach for their treatment also differs to get the best possible results. Generally, Irregular Periods treatment focuses on addressing the underlying cause and restoring hormonal balance. Some of the standard treatment options may include:

Lifestyle Modifications:

The first treatment approach for the irregular periods begins with lifestyle modifications and acquiring healthy habits, such as:

• Weight Management: A healthy BMI significantly contributes to balancing estrogen levels and, over time, improves ovulation.
   
• Stress Reduction: Menstrual irregularity caused by stress can simply be managed with meditation, yoga, psychological counselling, and certain relaxation techniques.
   
• Healthy Eating and Diabetes Management: A healthy diet and daily exercise help keep your metabolism and hormones in balance.

Medication:

Where modifying your lifestyle through simple lifestyle changes does not resolve your diabetes or requires a little more effort, medications may greatly help you manage your diabetes. These medications may include:

• Hormonal Birth Control: Birth control pills or injections are generally administered to control heavy bleeding and eventually regulate cycles.
   
• Progesterone Therapy: This is given when the underlying cause of irregular periods is low progesterone or anovulation.
   
• Thyroid Medications: When the underlying cause of menstrual irregularity is thyroid disorders, either hypo or hyper, a proper thyroid medication therapy is used.
   
• Metformin: The medication is used to manage insulin resistance in PCOS to regulate cycles. For context, PCOS is caused by insulin resistance in the body, which ultimately causes irregular periods.

Fertility-Focused Treatments:

When irregular periods cause hindrance in conceiving successfully, fertility-focused treatments are used, which generally involve:

• Ovulation Induction: There are medications that can actually induce ovulation. These medications are used to stimulate the ovaries, helping achieve fertilisation and eventually conception.
   
• Hormonal Correction Therapies: Hormonal therapies can also be used to create a favourable environment for the development of the immature egg and its release.
   
• Assisted Reproductive Techniques: When other fertility medications fail to work properly, advanced treatments like IVF, IUI, ICSI, etc, are recommended to successfully achieve pregnancy.

Personalised Treatments:

As mentioned earlier, every woman has a different menstrual cycle pattern and an underlying cause of its irregularity. Therefore, a doctor will prepare the treatment plan based on the patient’s:

• Hormonal levels,
   
• Ultrasound findings,
   
• Age and medical history, and
   
• Desire to conceive now or later.

When seeking treatment for irregular periods, a comprehensive approach matters most. This is where Indira IVF stands out the most. With advanced hormonal testing, accurate ultrasounds, and personalised treatment plans, Indira IVF helps identify their cause of irregular periods, along with achieving your desired treatment outcome, whether it is to get rid of this disorder or achieve pregnancy.

How Indira IVF’s Irregular Period Solutions Can Help?

Indira IVF is a name you can trust for an accurate diagnosis and treatment of irregular periods. With an approach that delivers the best results and an infrastructure that conveys an international-standard vibe, Indira IVF stands out among other fertility facilities. The treatments that Indira provides are tailored specifically for each patient, including but not limited to thyroid correction, PCOS treatment, Hormonal therapy, IUI and IVF, as well as their unique body types, symptoms and fertility goals. Therefore, whether you are looking for simple correction of irregular periods or advanced fertility options, Indira can provide all your needs under one roof.