Even though women share the same frame of physiology and functioning when it comes to periods, every woman is unique. In general, periods that happen every 21-35 days and last for 3-7 days can be considered normal. It’s also normal to notice small changes from month to month, depending on factors like stress, physical activity, mental state, and nutrition.
How are periods regulated?
A complex system of hormones regulates periods. Starting from a small gland in the brain called the pituitary gland. This gland triggers the development of eggs in the ovaries in a regular pattern through two hormones, FSH (Follicle Stimulating Hormone) and LH (Luteinizing Hormone). The ovaries respond to these vital hormones by producing estrogen and progesterone. You need to understand that the levels of these hormones in the blood fluctuate throughout the cycle, and anything that can affect them will affect the period.
Another vital gland that affects periods is the thyroid. Disturbed thyroid function could result in irregular/absent periods.
Causes of irregular periods
As mentioned above, slight changes from month to month could be normal. A delay of a day or two is not concerning. Causes of irregular periods include:
- Puberty or menopause: It’s normal to have irregular periods during the first year after puberty. It’s also normal to have irregular periods when approaching menopause (45 years old or older).
- Stress: Stress is not merely a mental state. Stress causes physiological changes in the body disturbing many hormones. Cortisol, the main stress hormone, causes metabolic and hormonal changes that could lead to irregular periods or even missing periods completely.
- Nutrition: An unbalanced diet is related to menstrual irregularities. An extremely low-calorie diet could cause irregular/absent periods. That’s why women who desire to lose weight should follow a healthy diet plan. On the contrary, a diet high in fat and carbs will lead to being overweight which could interfere with the natural regulating mechanisms of periods.
- Exercise: Exercise is great for mental and physical health but high-intensity exercise for long periods of time will trigger a stress response in the body. This can cause irregular periods. Also, a sedentary lifestyle will aggravate preexisting irregularities like those seen in PCOS.
- Hormonal contraception: If a woman is taking birth control pills, injections, or implants, and she notices a change in the pattern of her period, those contraception methods should be checked by a doctor to see if they’re causing the problem.
- PCOS: Poly Cystic Ovarian Syndrome or PCOS is a condition in which hormonal disruptions on multiple levels (sex hormones, insulin, LH …) cause irregular/absent ovulation. This condition is common in females and has many consequences on their health, fertility, and mental health.
- Endometriosis: In the case of endometriosis, cells from the lining of the uterus grow in other areas, like the fallopian tubes, or the ovary. These cells respond to hormones just like a cell in the uterus which cause them to thicken and shed during each menstrual cycle. Having endometriosis could be the cause of irregular periods.
- Thyroid: The thyroid is a major gland that regulates all metabolic processes in the body. Changes in the thyroid hormones interfere with the system regulating menstruation causing disturbed periods. Thyroid disorders are common in women.
Other less common medical causes of irregular periods include:
- Type-1 diabetes
- Cushing’s syndrome
- Primary ovarian insufficiency
- Congenital adrenal hyperplasia
- Hormone-secreting tumors
When should I see a doctor?
There’s no need to see a doctor if you’re going through puberty, or if you have had slightly irregular periods throughout your life. However, make sure to seek medical advice if:
- You’re under 45 and you notice a sudden change in your periods.
- Your cycles are shorter than 21 days or longer than 35 days for more than two months.
- Your periods last longer than 7 days
- Have trouble conceiving with irregular periods
Please note that all the information in this article is for educational purposes only. Your doctor is the one qualified to give you medical recommendations.
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