There are a number of reasons why a female might experience irregular periods. Many factors can disrupt the delicate hormone balance that is required for a regular menstrual cycle. Whilst the length of a menstrual cycle can differ from woman to woman, most find that it is between 21 and 35 days long. Irregular cycles occur when the duration falls outside of this range and/or the length of the cycle varies month by month (the gap between periods keeps changing).
The best way of regulating your periods is to identify the reason for the irregularity and rectify that. Some of the most common causes are listed below.
Young girls and women who are approaching the menopause often experience menstrual irregularities. For those who have only recently started their periods, it can take over two years for their cycles to become regular; time and patience are likely to be the best treatment. Women who are starting to experience symptoms of the menopause can use hormonal treatment to regulate their cycles; this also protects against the damaging effects of low oestrogen, which include reduced bone strength and increased risk of breast cancer. Natural oestrogens and progesterones are the preferred option.
The intrauterine device (IUD) and oral contraceptive pill contain synthetic oestrogen and progesterone (progestin) analogues. They actually have widespread use as a means of regulating the menstrual cycle. Many women who are fitted with an IUD will stop having periods altogether and those on the pill will have a withdrawal bleed once a month. However, sometimes it takes time to identify a form of hormonal treatment that is suitable and if irregular periods persist three months after commencing treatment, it is probably worth switching to an alternative.
Excessive weight gain or loss, too much exercise, a poor or irregular diet, and stress can all have an impact on the menstrual cycle. Moderating these factors can help to regulate the cycle. If stress is starting to have an effect on your physical and emotional health seeing a trained counsellor may help. Ensure that any changes in weight are controlled and not as a result of an extreme diet.
Ovulatory disorders, such as polycystic ovary syndrome, and thyroid problems frequently lead to fluctuations in the menstrual cycle. The best way of regulating the cycle in these instances is to treat the underlying condition. For example, PCOS is frequently associated with insulin resistance and thus, losing weight can drastically improve many of the associated symptoms. Hypothyroidism (an underactive thyroid gland) commonly causes irregular periods. Thyroid hormone replacement can be very effective at resolving this issue. Endometriosis occurs when endometrial tissue forms elsewhere in the body, potentially causing pain, heavy bleeding and irregular periods. Treating endometriosis is challenging; medication can provide temporary relief by masking the symptoms and surgical removal of accessible endometrial deposits is sometimes successful, but unfortunately, relapse is common. Some patients find that the only way to completely resolve their symptoms is to undergo a radical surgical procedure, such as an hysterectomy.
Some women find that after an infection or following a surgical procedure, they experience irregular periods. This can happen even if the uterus and reproductive organs are not the source of the infection or the area being operated on. Essentially the body goes into a state of physiological stress, which then disrupts the menstrual cycle, in the same way that psychological stress does. Provided you had a regular menstrual cycle before, with time your periods should become regular again.
In rare cases an irregular menstrual cycle can be a sign of something more serious, such as cervical or ovarian cancer. For this reason it is essential that if you are experiencing any irregular bleeding you consult a doctor so that they can eliminate the more severe conditions, identify the underlying cause and find a treatment approach that works for you.
The options for regulating your periods will depend heavily on whether you wish to become pregnant. Many women only start exploring ways of regulating their cycle because they are hoping to conceive. With irregular cycles, it is hard to calculate if and when ovulation is occurring and this can make getting pregnant challenging. The birth control pill is frequently prescribed to regulate periods, but will not be suitable for women trying to conceive. For these women, exploring the underlying reasons for their irregular cycles in more detail may be necessary. They may also have to resort to alternative hormone therapies, such as clomiphene citrate, or gonadotrophins to help stimulate ovulation.
- Pasquali, R, et al. “The Impact of Obesity on Reproduction in Women with Polycystic Ovary Syndrome.” BJOG, vol. 113, no. 10, Oct. 2006, pp. 1148–1159., doi:10.1111/j.1471-0528.2006.00990.x.
- “Irregular Periods.” NHS, www.nhs.uk/conditions/irregular-periods/. Page last reviewed: 09/04/2018.
- Briden, L. “Irregular Periods? It Could Be Your Thyroid.” Lara Briden – The Period Revolutionary, 31 Oct. 2014, www.larabriden.com/irregular-periods-think-about-thyroid/.