A variety of reasons
There are two groups of women in whom irregular menstruation can be expected with a high degree of probability, young girls who are just beginning to menstruate, and women approaching menopause. In both cases, menstrual irregularity is usually associated with ovulation, which in itself can occur irregularly. “These are women located at different ends of the childbearing period, says Dr. Rabin. The ovaries of a young girl are just beginning to produce mature eggs. At this time, your ovulation may not occur every month, so you may not have menstruation every month or are irregular. If there are no regular ovulations, there will be no regular menstruation, which is characteristic of the beginning and end of the childbearing period of a woman’s life. ”
However, if the menstrual cycles are irregularly absent, they become rare, if the menses are very painful or are accompanied by too much bleeding, you should consult a doctor. "Irregular menstruation or abnormal vaginal bleeding can be signs of endometrial cancer of the uterus or ovaries, and this is of increasing concern as women age, because the number of cancers increases with age," warns Dr. Rabin.
There are other causes of abnormal bleeding. These can be fibroids, in which there are often excessively heavy bleeding, it can be benign growths in the ovaries, other benign tumors in the mucous membrane of the uterus. Adenomyosis, endometrial ingrowth into the uterine wall, can lead to heavy bleeding and most often occurs in women after forty years. Endometriosis can also cause very heavy bleeding as well as bleeding between ovulation and menstruation. You may experience abnormal bleeding if there is a polyp in the uterus or on the cervix. “These are all functional problems,” explains Dr. Rabin.
“Bleeding and irregular ovulation may or may not be associated with dysfunction of the reproductive system,” notes Dr. Rabin. Diseases of the thyroid gland, diabetes, blood diseases can lead to irregular menstruation. Ovulation is affected by hormonal disorders, which have many causes, including a pituitary tumor; as a result, heavy bleeding or irregular bleeding may also occur.
Treatment depends on the cause of the dysfunction. There are a number of medications, including hormone-based drugs, such as oral contraceptives and antiprostaglandins, that eliminate excessive bleeding. Oral contraceptives are often prescribed for regular menstruation. If bleeding is caused by tumors in the uterus, relief will come from drugs that cause wrinkling of myomas, or their surgical removal.
Before you begin treatment, your doctor will want to make sure that you are not pregnant, especially if you did not have one or more of your periods or were irregular; It is 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 very life. Pain in the pelvic area is one of the first signs of ectopic pregnancy, when they appear, you should immediately consult a doctor.
Dysfunction of the ovaries
If it is determined 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 about amenorrhea, menstruation may be irregular, or instead of normal bleeding there may be slight bleeding, leaving spots on the laundry. (Some women have pain in the middle of the menstrual cycle, indicating ovulation. This is completely normal and is usually a sign that you are ovulating.)
If your doctor suspects that menstrual irregularities are 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 in the hypothalamus, a section of the brain that regulates temperature. There are other tests for determining ovulation, including an endometrial biopsy, an outpatient procedure that a doctor removes a small piece of the endometrium that is used for tests to determine the level of hormones and signs of ovulation, as well as for cancer.
Ovulation may be absent for various reasons. This may be stress, excessive exercise, eating disorders. Disruption 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 with the use of drugs intended for the treatment of infertility, such as clomifentirate (clomid). Ovulation is affected by the state of the thyroid gland, ovarian and adrenal tumors.