According to FIGO (International Federation of Gynecology and Obstetrics) and ACOG (American College of Obstetricians and Gynecologists), the criteria for a “normal menstrual cycle” (more commonly known as periods) is if the menstrual cycle consistently occurs every 24 to 38 days, with menstrual bleeding lasting between 4.5 to 8 days with a typical loss of 5-80 ml of blood loss every cycle. Menstrual cycles occurring outside these parameters are classified as “abnormal” or “irregular”. 

This includes too short (<24days), too long (>38 days), missed or unpredictable menstrual cycles. Irregular menstruation affects approximately 14–25% of women globally. In India, studies report a higher prevalence—ranging from 25% to 35.7%.

Most Common Causes of Irregular Periods:

  • Polycystic Ovary Syndrome (PCOS): This is the most common cause for irregular periods affecting up to 20% of reproductive-age women in India. This is mainly due to excess androgen. 
  • Thyroid Disorders: Both hypothyroidism and hyperthyroidism cause irregular periods  as both these conditions affect hypothalamic-pituitary-ovarian (HPO) axis. Studies show ~15–30% of women with thyroid disease experience menstrual irregularities.
  • Perimenopause: Women in their 40s who are in perimenopausal age, often experience irregular menstrual cycles due to the deficiency or fluctuating levels of oestrogen and progesterone. 
  • Contraceptives & Medications: OCPs or hormonal pills can cause irregular periods especially within the first 2-3 months but it usually settles with time. 
  • Uterine Fibroids or Polyps: Uterine fibroids are non cancerous and can cause irregular periods based on their size and location.
  • Functional Hypothalamic Amenorrhea (FHA): This occurs due to sudden weight loss, stress or excessive exercise.
  • Hyperprolactinemia: Pituitary tumors (adenomas) may cause irregular menstruation.

Treatment/Management:

The treatment depends on the cause and the severity. While many women benefit with lifestyle interventions, there may be a need for medical intervention depending on the cause.

  • Lifestyle Changes: Healthy diet, regular physical activity and weight reduction are very important especially in PCOS. A 5-10% reduction in weight can regularise periods and can attain hormonal balance. 
  • Hormonal Therapy: It is the first line of treatment and usually comprises a combination of OCPs and progesterone pills. 
  • Addressing the Underline Issue: Specific medical treatment is started to treat the underlying health condition. Eg. Thyroxine supplements for hypothyroidism, anti-thyroid drugs for hyperthyroidism, metformin for PCOS etc. 
  • Surgical Interventions: If the irregular periods are due to any polyps or fibroids then it can be managed surgically through polypectomy or myomectomy. 

Conclusion:

Irregular periods are a very common gynaecological condition. While having them occasionally may not be a concern but if you are consistently experiencing this then you need to seek medical help. Lifestyle interventions play a major role. 

Disclaimer: This article is written by Practo for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.