WHAT IS MENSTRUAL CYCLE?

The menstrual cycle is the time from the first day of a woman's period to the day before her next period.

DURATION OF FLOW

Most women have menstrual periods that last four to seven days. Less than 2 days and more than 7 days are abnormal. 

LENGTH OF MENSTRUAL CYCLE

The length of the menstrual cycle varies from woman to woman, but the average is to have periods every 28 days. Regular cycles that are longer or shorter than this, from 21 to 40 days, are normal. 

VOLUME OF FLOW

The normal flow is 30 ml per period. More than 80 ml per period is abnormal.  

WHAT CAUSES ABNORMAL MENSTRUATION (PERIODS)?

There are many causes of abnormal periods, ranging from stress to more serious underlying medical conditions:

A) STRESS AND LIFESTYLE FACTORS:

GAINING OR LOSING A SIGNIFICANT AMOUNT OF WEIGHT:

With an increase in weight, you may start experiencing symptoms of irregular periods such as: 

  • Skipping menstrual cycles
  • Heavy blood flow during periods
  • Periods lasting more than five to seven days and 
  • Bleeding when not menstruating

DIETING:

A diet too low in fat can also throw your menstrual cycle off the track.

Eating an appropriate amount of fats is also essential in balancing hormones.

The timing of menstruation, when the uterus sheds its lining, is regulated by the hormones estrogen, progesterone and testosterone. 

Research has shown that your diet can affect hormones, and subsequently, your menstrual cycle. 

B) CHANGES IN EXERCISE ROUTINES

Exercise might help to reduce painful periods by its effects on prostaglandins if you have secondary dysmenorrhea (medical term for menstrual cramps). Just like with primary dysmenorrhea, prostaglandins play a major role in causing uterine contractions and cramping even with underlying pathology. 

Don't be alarmed if you notice that your periods become a bit lighter once you start a regular exercise routine. The same hormonal changes that can stop your periods altogether can exert a weaker effect on your body and just cause a lighter flow. 

As a result of a physiologic stressor, like strenuous exercise or significant weight loss, you will not ovulate. If you do not ovulate, the changes that trigger your menstruation will not happen and you will miss your period. 

Regular exercise can cause subtle changes in your hormone levels that interfere with the cyclic buildup and shedding of the lining of your uterus. The lining of your uterus may respond to these mixed up signals by randomly shedding, which causes the breakthrough bleeding. This bleeding may be dark or bright red. Typically it is just spotting or a flow lighter than your typical period. You may also experience breakthrough bleeding during or immediately after strenuous exercise. 

C) TRAVEL

While many hormones are involved in the control of your menstrual cycle, two important ones are known to be directly related to travel and stress: cortisol and melatonin. 

Travel often goes hand-in-hand with stress, and this can cause cortisol levels to fluctuate. Changes in sleep schedules, like early flights and time zone changes, and added stress can have some effect on these hormone levels. When the levels of these two hormones in your body change, your ovulation schedule can also shift. A period that might show up earlier or later than expected. 

Illness or other disruptions in a woman's daily routine can have an impact on her menstrual cycle. 

D) PREGNANCY 

Pregnancy leads to amenorrhea (the absence of periods that is not due to underlying reasons).

E) BIRTH CONTROL PILLS

Most birth control pills contain a combination of the hormones estrogen and progestin(some contain progestin alone). 

Going on or off birth control pills can affect menstruation. Some women have irregular or missed periods for up to six months after discontinuing birth control pills. 

Women who take birth control pills that contain progestin only may have bleeding between periods. 

F) UTERINE POLYPS OR FIBROIDS

These tumors are usually benign, but they may cause heavy bleeding and pain during periods. 

G) ENDOMETRIOSIS

Endometriosis may cause abnormal bleeding, cramps, or pain before and during periods, and painful intercourse.

H) PELVIC INFLAMMATORY DISEASE

Pelvic inflammatory disease (PID) is a bacterial infection that affects the female reproductive system. 

Symptoms of PID include a heavy vaginal discharge with an unpleasant odor, irregular periods, pain in the pelvic and lower abdominal areas, fever, nausea, vomiting, or diarrhea.

I) POLYCYSTIC OVARY SYNDROME

In polycystic ovary syndrome (PCOS), the ovaries make large amounts of androgens, which are male hormones. 

Small fluid-filled sacs (cysts) may form in the ovaries. Sometimes a woman with polycystic ovary syndrome will have irregular periods or stop menstruating completely. 

In addition, the condition is associated with obesity, infertility, and hirsutism (excessive hair growth and acne). 

J) PREMATURE OVARIAN INSUFFICIENCY

This condition occurs in women under age 40 whose ovaries do not function normally.

The menstrual cycle stops, similar to menopause.

OTHER CAUSES of abnormal menstruation include:

  • Uterine cancer or cervical cancer
  • Medications, such as steroids or anticoagulant drugs (blood thinners)
  • Medical conditions, such as bleeding disorders, and under-or overactive thyroid gland, or pituitary disorders that affect hormonal balance
  • Complications associated with pregnancy, including miscarriage or an ectopic pregnancy (the fertilized egg is implanted outside the uterus; for example, within the fallopian tube) 

PREVENTION AND TREATMENT OF IRREGULAR PERIODS

  • Firstly, do a pregnancy test and rule out pregnancy.
  • If stress is a possible culprit in your irregular cycle, try stress management techniques, such as meditation, yoga, tai chi, visualization, and biofeedback. 
  • Avoid over-exercising and try not to diet excessively, as doing so can interfere with your menstrual cycle.
  • Oral contraceptive pills may be prescribed to get your period back on track. 
  • But if you’d rather travel the natural treatment road, consider black cohosh. This medicinal herb is sometimes used for menstrual irregularities and premenstrual syndrome, though rigorous scientific studies haven’t verified these properties. Black cohosh should not be used if you have any symptoms or a past history of liver disease.

    In a nutshell, lifestyle and diet modifications can help in bringing your delayed or irregular periods back on track. It is advisable to be in touch with your gynaecologist and go for regular check-ups.