A variety of reasons
There are two groups of women whose irregular periods can be expected with a high degree of probability, young girls who are just starting to menstruate, and women approaching menopause. In both cases, irregular menstruation is usually associated with ovulation, which in itself can occur irregularly. “These are women located at different ends of the childbearing period,” remarks Dr. Rabin. The ovaries of a young girl are just starting to produce mature eggs. At this time, you may not ovulate every month, so you may not have menstruation every month or are irregular. If there is no regular ovulation, there will be no regular menstruation, which is characteristic of the beginning and end of the childbearing period of a woman’s life. ”
Nevertheless, if the menstrual cycles are irregular, absent, they become rare, if the menstruation is very painful or accompanied by too much bleeding, you should consult a doctor. “Irregular menstruation or abnormal vaginal bleeding can be signs of cancer of the uterine or ovarian endometrium, and this is becoming increasingly worrying as a woman ages because the number of cancers increases with age,” warns Dr. Rabin.
There are other causes of abnormal bleeding. It can be fibroids, in which excessively heavy bleeding often occurs, it can be benign growths in the ovaries, other benign neoplasms in the uterine mucosa. Adenomyosis, the growth of the endometrium in the uterine wall, can lead to heavy bleeding and most often occurs in women after forty years. Endometriosis can also cause very severe bleeding, as well as bleeding between ovulation and menstruation. You may begin to have abnormal bleeding if there is a polyp in the uterus or on the cervix. “These are all functional issues,” explains Dr. Rabin.
“Bleeding and irregular ovulation may not be associated with reproductive system dysfunction,” notes Dr. Rabin. Thyroid diseases, diabetes, blood diseases can lead to irregular menstruation. Ovulation is affected by hormonal disorders, which have many causes, including a pituitary tumor; heavy or irregular bleeding can also occur as a result.
Treatment depends on the cause of the dysfunction. There are a number of medications, including hormone-based medications, such as oral contraceptives and antiprostaglandins, that relieve excessive bleeding. To establish regular menstruation, oral contraceptives are often prescribed. If bleeding is caused by neoplasms in the uterus, medications that cause wrinkling of myomas, or their surgical removal, will bring relief.
Before starting treatment, your doctor will want to make sure that you are not pregnant, especially if you did not have one or more periods or were irregular; It’s important to find out if there is an ectopic pregnancy when a fertilized egg is implanted outside the uterus, which threatens not only your ability to give birth, but also your life itself. Pain in the pelvic area is one of the first signs of an ectopic pregnancy, if they occur, you should immediately consult a doctor.
If it is established that you are not pregnant, your doctor may be interested in whether you are ovulating. Women who have normal ovulation usually menstruate regularly. If ovulation does not occur, in this case they speak of amenorrhea, menstruation may be irregular, or instead of normal bleeding, there may be minor spotting that stains the laundry. (Some women have pain in the middle of the menstrual cycle that indicates ovulation. This is completely normal and is usually a sign that you are ovulating.)
If your doctor suspects that irregular menstruation is caused by a lack of ovulation, he may ask you to track changes in basal temperature. During ovulation, the temperature rises by 0.5 degrees and remains elevated until the onset of menstruation. This is due to the intake of the hormone progesterone on the hypothalamus, a section of the brain that regulates temperature. There are other tests to determine ovulation, including an endometrial biopsy, an outpatient procedure that involves removing a small piece of the endometrium, which is used to test for hormones and signs of ovulation, as well as cancer.
Ovulation may be absent for various reasons. It can be stress, excessive physical activity, malnutrition. Imbalance of hormonal balance leads to an increase in the ovaries due to the fact that they contain many partially matured, but not released egg cells, these are the so-called polycystic ovaries. The normal functioning of the ovaries is often restored by using medications designed to treat infertility, such as clomiphencitrate (clomid). Ovulation is affected by the state of the thyroid gland, a tumor of the ovaries and adrenal glands.