Abnormal periods may include bleeding more than once a month, skipping cycles, or no menstrual bleeding at all.
An average menstrual cycle length is 28 days, but only about 25% of women have a period every 28 days. Normal cycles occur anywhere from every 26 to every 35 days. Most women bleed for 3 days to 7 days. During the heaviest day (usually cycle day 2 or 3), most women have to change a pad or tampon every 2 to 3 hours.
Lots of women will have an occasional abnormal cycle in their lifetime. Typically being late by a week once or twice a year, for example, is nothing to be concerned about.
Causes of abnormal periods
Many things can cause abnormalities in your cycle. Conditions such as severe illness, excessive exercise, stress and abnormally high or low weight can cause you to skip periods.
Causes of abnormal menstrual cycles that need to be excluded are:
- Polycystic ovary syndrome (PCOS)
- Progesterone deficiency
- Uterine fibroids
- Uterine polyps
- Hypothalamic disease – usually associated with very low weight or extreme exercise
- Thyroid disease
- Elevated prolactin level
- Peri-menopause or menopause
- Other more rare problems like cervical or uterine cancer
How are abnormal periods diagnosed?
Blood testing can be performed to evaluate your ovarian reserve, your thyroid and prolactin levels, hypothalamic function and polycystic ovary syndrome (PCOS).
An ultrasound will diagnose polyps or fibroids. An HSG or saline sonogram can further evaluate structural abnormalities like polyps and fibroids.
Treatment options for abnormal periods or vaginal bleeding
Treatment of abnormal periods will depend on the cause. Fibroids and polyps will be removed surgically. PCOS is treated with weight loss, birth control pills, or ovulation induction medications if pregnancy is desired. Hypothalamic disease can be treated with weight gain and ovulation induction with fertility treatments. Thyroid disease and elevated prolactin are treated with medication.
Contact Texas Fertility Center San Antonio to make an appointment with Dr. Munch or Dr. Hudson and have an evaluation of your irregular menses and determine its impact on your fertility.