Warning signs of irregular periods: Learn how age and lifestyle affect menstrual health, and when to consult a healthcare professional.
Have you ever experienced unexpected changes in your menstrual cycle? You are not alone! According to the International Journal of Clinical Obstetrics and Gynaecology, approximately 50 women of all ages, ranging from 15 to 55 years old, visit gynaecological outpatient departments (OPDs) each week to share their stories of irregular bleeding. It is vital to solve the causes behind these disorders for treatment and to protect your reproductive health. The various age groups affected by menstrual irregularities have warning signs that may show problems growing beyond simple hormonal fluctuations.
What is irregular bleeding?
“Irregular bleeding refers to variations in the menstrual cycle, which can include changes in timing, flow, or duration of periods. While some fluctuations can be normal, particularly during puberty or the approach to menopause, persistent irregularities warrant investigation,” says gynaecologist Dr Mansi Medhekar, Lilavati Hospital. The causes and implications of irregular bleeding vary significantly across different age groups, as reported in the journal Cureus.
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Irregular bleeding in adolescents (12-18 years)
For many girls, menstruation begins around the age of 11 or 12. However, their hormone levels and reproductive structures usually become fully developed only by 15 or 16.
Here are some key considerations for this age group:
- Normal variation: Irregular menstrual cycles, ranging from light to heavy flow, are common until the age of 16. If no alarming symptoms, such as weight gain, fatigue, or excessive pain, accompany these irregularities, further investigation may not be necessary.
- Lifestyle factors: Maintaining a healthy lifestyle, including a balanced diet, sufficient sleep, and regular physical activity, is critical for supporting a healthy reproductive system, according to the Journal of Nepal Medical Association.
- Medical attention: If irregular periods persist or if other symptoms arise, your gynaecologist may conduct hormonal tests or ultrasounds for a more in-depth diagnosis.
2. Irregular bleeding in the reproductive age group (18-45 years)
During the reproductive years, irregular menstrual cycles are common and can be caused by a variety of factors. Dr Mansi Medhekar shares common causes of irregular periods:
- Hormonal issues: Conditions like Polycystic Ovary Syndrome (PCOS), thyroid disorders, and irregular use of oral contraceptives can disrupt hormonal balance.
- Ovarian cysts: Conditions such as dermoid cysts or cystadenomas can cause irregularities and may require surgical intervention.
- Post-pregnancy changes: Irregularities can occur 3-6 months after a pregnancy, whether from abortion or delivery. Typically, these are self-limiting if no retained products are present, as noted in the Journal of Clinical Obstetrics and Gynaecology.
- Obesity: Poor lifestyle choices can lead to weight gain, which might cause missed or heavy bleeding. Lifestyle modifications and structured diets are often recommended. Sometimes, medication may also be necessary for those struggling to lose weight, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
- Fibroids and polyps: Benign growths in the uterus can lead to heavy or painful bleeding. These can often be diagnosed via ultrasound.
- Cervical erosions: This condition may cause sporadic bleeding and may require outpatient treatments such as cauterisation.
- Lifestyle influences: Women with night shifts, poor sleep patterns, or those who smoke and drink excessively may also experience irregularities, as per Frontiers in Human Neuroscience.
3. Irregular bleeding during perimenopause (45-55 years)
The perimenopausal stage, occurring between 45 and 55 years, presents its unique challenges as per the Maturitas journal:
- Hormonal imbalances: This age group also experiences hormonal fluctuations, resulting in irregular cycles similar to those observed in adolescents.
- Health considerations: “Women in this category may also face local causes of irregular menses, such as fibroids and polyps. Conditions like uncontrolled diabetes, thyroid issues, or hypertension can exacerbate these symptoms,” says Dr Medhekar.
- Management: Lifestyle changes remain important, alongside the possible need for micronutrients and multivitamins, as recommended by the World Health Organisation. While many cases can be managed with short-term medications, some may require surgical intervention.
Warning signs to watch for irregular periods
Irregular periods can be a sign of more serious health issues. Dr Mansi Medhekar shares some warning signs to consider:
- Heavy bleeding: Soaking through a pad or tampon every hour for several hours might require immediate attention.
- Persistent pain: Severe abdominal or pelvic pain accompanying irregular bleeding can signal underlying conditions.
- Cycle changes after age 40: If your cycles suddenly become irregular after years of regularity, it may be a sign that evaluation is needed.
- Unexplained weight changes: Significant weight gain or loss can impact your menstrual cycle and should not be overlooked.
- Other symptoms: If you experience accompanying symptoms, such as excessive fatigue, mood swings, or unexplained hair growth, it is recommended to consult your doctor.
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