Period abnormalities are a significant health concern for many women, impacting their physical health, emotional wellbeing, and daily life. The right treatment can restore your comfort, confidence, and improve your fertility.
Period abnormalities encompass a range of issues related to menstrual cycles, including irregular periods, heavy bleeding (menorrhagia), scanty bleeding (oligomenorrhoea), painful periods (dysmenorrhoea), and the absence of periods (amenorrhoea). If you are experiencing any abnormality in your menstrual cycle, it is important to seek medical advice as early diagnosis and treatment can make a substantial difference in your quality of life and prevent long-term health problems.
Menstrual disorders are a common cause of gynaecologist visits in Australia, with about 25% of Australian women suffering from menorrhagia, and dysmenorrhoea affecting up to 90% of adolescent girls.
The causes of abnormal periods are diverse, ranging from hormonal imbalances and underlying health conditions to less pathological reasons such as lifestyle factors or simple genetic predisposition.
Previously known as polycystic ovary syndrome or PCOS, PMOS is a prevalent hormonal disorder characterised by enlarged ovaries containing multiple cysts. Elevated levels of androgens (male hormones) can also disrupt your menstrual cycles. PMOS is often associated with irregular periods or amenorrhoea (absent periods).
The thyroid is a butterfly-shaped gland located at the base of your throat, and produces hormones that affect multiple systems in the body including the function of your ovaries. An underactive thyroid (hypothyroidism) can lead to heavy or unusually frequent periods, or conversely, infrequent or entirely absent periods. Women with an overactive thyroid (hyperthyroidism) may experience infrequent or no periods; when they do have a menstrual period, it is likely to be unusually short in duration and involve very light bleeding.
Endometriosis is a common gynaecological condition where glandular tissue similar to the lining of the uterus grows elsewhere outside the uterus, often causing heavy and debilitatingly painful periods. Women with endometriosis often see a significant delay in diagnosis due to normalising their experience with their menstrual periods.
Uterine fibroids are benign and non-cancerous growths in the uterus. Although at least half of all women with fibroids are not symptomatic, those who do experience symptoms may find their menstrual bleeding is very heavy or associated with significant pain.
High levels of stress, significant weight changes, insufficient sleep, and extreme physical activity can disrupt your menstrual cycle through disturbing your hormone balance. Physiological stress, eating disorders, or excessive exercise can lead to amenorrhoea, while being overweight or obese can be associated with abnormally heavy periods. Women who are in the first several months of post-partum or breastfeeding often find their periods cease and will resume naturally once they have finished breastfeeding.
Certain forms of contraception are known to cause changes in menstrual bleeding patterns. Hormone-based IUDs, injections, vaginal rings, and pills can make your periods lighter, less frequent, or stop them altogether. Conversely, copper IUDs may make periods heavier.
As abnormal periods are often an indicator of a hormone imbalance or problem with ovulation, many women with menstrual disorders will also have trouble falling pregnant.
Menstrual cycles that are unusually long (longer than 35 days between periods) mean that you ovulate fewer times per year, which gives you fewer opportunities to conceive. Conversely, periods that are unusually frequent (with cycles shorter than 24 days), can be a sign of lower ovarian reserve or make it more difficult to time intercourse during your fertile time, i.e. around the time of ovulation. Women with irregular periods may also find it challenging to predict their fertility windows. Some women, despite having periods, may not ovulate during their cycles and are not likely to conceive without appropriate fertility treatment, such as ovulation induction.
Treatment for period abnormalities is tailored to your specific condition and its underlying cause, and whether you are trying for a pregnancy.
Hormone contraceptives including pills and vaginal rings, can help to regulate your menstrual cycle and reduce symptoms such as heavy bleeding and pain. Abnormal periods from conditions such as endometriosis or uterine fibroids may also benefit from these hormone medications, but they will not be suitable if you are trying to conceive.
Non-steroidal anti-inflammatory medications such as ibuprofen can alleviate menstrual pain, while tranexamic acid and oral progestins can help to manage heavy periods.
If your menstrual abnormalities are a result of lifestyle factors, addressing these accordingly can help to restore normal periods and ovulation. These steps can include dietary changes, stress management techniques, and regular exercise, which can be particularly helpful for period disturbances associated with PMOS or stress.
In cases where medication is ineffective and your symptoms are severe, Dr Huang may suggest an appropriate surgical treatment such as a myomectomy (removal of uterine fibroids), laparoscopy, or hysteroscopy to treat the underlying cause. For women who have completed their families, surgical removal of the uterus (hysterectomy) can be considered.
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Testing may help identify ovulation issues, hormone imbalances, ovarian reserve concerns and other factors affecting fertility.
