Does something not feel right?
Irregular periods are more common than you may think. Irregularities in your menstrual cycle can have many causes from underlying health conditions, hormonal imbalances or simply abrupt changes in lifestyle.
An irregular period is considered when any of the following occur (1):
- A menstrual cycle length that is less than 21 days or more than 35 days
- Bleeding for more than 7 days at a time
- Three or more consecutive missed periods
- Abnormal changes in menstrual flow – heavier or lighter than usual
- Extreme pain, cramping, nausea or vomiting alongside period
- Bleeding or spotting that occurs between periods, post-menopause or after sex
So, what are the main reasons you may be seeing irregularities in your cycle?
10 reasons you may be experiencing irregular periods
1. Pregnancy or breastfeeding
Way to state the obvious! But this is this first one to rule out.
Pregnancy will lead to you missing your period in preparation to bearing a child. If this is a possibility (i.e. you miss your period and have had sex recently), then you can take a pregnancy test at home or book an appointment with your doctor to see whether you are in fact pregnant.
Following childbirth, a period may be absent for several months due to the hormone prolactin (2). Prolactin is the hormone that causes breast milk production, however it also suppresses your reproductive hormones simultaneously resulting in an absent or extremely light period (2).
Undernourishment, i.e., not eating enough or too little of any macronutrient, is a major factor contributing to hypothalamic amenorrhea (loss of period), particularly for those with eating disorders. When your body is undernourished, it does not prioritise the reproductive cycle as it needs to preserve energy for the bodily functions that are vital for life therefore it shuts of that vital connection between the hypothalamus and the ovaries (3).
If this is you and you are hesitant to start eating more, it may be some time for some additional support to make sure that you are fuelling yourself correctly in order to get your whole body working properly (and hence get that period back!).
This may come alongside undernourishment, but over exercising can in fact be a bad thing for your hormones. Remember that exercise is a form of stress on your body, therefore excessive exercise can interfere with the hormones responsible for menstruation (4).
4. Hormonal Contraception
Hormonal contraception methods such as the oral contraceptive pill, the implanon and intrauterine devices (IUDs) can cause irregular bleeding, spotting between periods, changes in your natural periods flow or even a complete absence of a period. This is because these methods secrete synthetic forms of a woman’s hormone to prevent pregnancy, resulting in abnormalities in the natural female menstrual cycle.
4. Hormonal Contraception
Some pain is completely normal within the normal phases of your menstrual cycle. However, this pain should not be severe or affect your quality of life.
Pain within your menstrual cycle becomes a concern when the severity of the pain is disrupting your day-to-day functioning. Endometriosis, pelvic inflammatory disease, IUD use, fibroids and polyps may all be causes of this.
5. Stress & Lifestyle Factors
Significant stress has been linked to changes in normal menstrual cycles, affecting the length, ovulation occurrence and pain experienced throughout the duration of the cycle (5).
In addition to this, lifestyle factors such as sudden weight loss or weight gain, dieting, travel, illness or other various changes in a woman’s routine can impact her menstrual cycle (1).
6. Polycystic Ovarian Syndrome (PCOS)
PCOS is a common hormonal syndrome where there is an excess in androgens (male hormones) and/or insulin resistance. One of the major signs of PCOS is irregular or absent periods. This is due to the hormonal imbalances commonly seen in PCOS, preventing consistent ovulation (6).
Endometriosis is another chronic condition affecting your menstruation. Characterised by the endometrium (cells lining the uterus) growing outside the uterus, endometriosis can cause heavier period flow as well as abnormal abdominal pain during menstruation (7).
8. Thyroid Disorders
The thyroid gland is vital for many processes and functions of the body – including menstruation (8). Hypothyroidism is a condition where the body does not product enough thyroid hormones, resulting in a general slowing down of many of the body’s functions and can create issues for the menstrual cycle (8).
Those with hypothyroidism may experience a range of different symptoms associated with their menstrual changes including elongated length, heavy bleeding or a complete loss of their period (8).
Perimenopause generally begins in a woman’s 40s and marks the transition phase prior to menopause. Lasting as short as a few months or up to 8 years, hormone levels greatly fluctuate then gradually decline (9). However, it is important to rule out other potential causes of menstrual irregularity, so do not just assume you have entered early menopause.
10. Presence of Fibroids or Polyps
Uterine polyps or uterine fibroids are types of growths that are found in the uterus. Polyps can be described as small and benign growths, whilst fibroids are tumours. Although these are benign, they may cause heavy bleeding and pain during periods (1). Additionally, they may cause discomfort if enlarged due to putting pressure on the bladder or rectum (1).
What to do now?
Is this information overwhelming?
In truth, we have only just touched the surface when it comes to factors affecting menstrual irregularity as there are so many potential underlying factors affecting this.
Inner Fit Nutrition has something exciting coming surrounding the topics of perimenopause and hormonal health for women so watch this space… email “Help – my period is out of whack!” to [email protected] to get added to the waitlist and be the first to find out about what’s to come.
Clinical Nutritionist (BSc).