Irregular menstruation, causes, symptoms and therapy

Irregular menstruation can be a cause for concern for many women.

Often the menstrual cycle is compared to a clock.
A cycle is considered regular if:

  • it lasts 21-35 days,
  • bleeding persists for 2-7 days.

A woman who menstruates every 4 weeks has a “regular” cycle and it seems that something is not normal if women do not have such a precise rhythm.
In fact, the majority of women do not always start a menstrual cycle after the same number of days after the start of the last one.

From puberty to menopause, women’s biochemical values increase and decrease with their own monthly rhythm called the menstrual cycle.

The term menstruation comes from the Latin word menstruus, which means “monthly”.

Regular menstruation is a sign that the body produces the appropriate hormones at the best possible rhythm for human reproduction.


Irregular menstruation during and after breastfeeding


  • The breastfeeding process stimulates sex hormones and milk production in the woman. The production of the hormone prolactin is increased to increase milk production and inhibits the return of menstruation. If the prolactin level is high enough, the action of estrogen and progesterone is inhibited and can block ovulation.
    The result is a lack of menstruation.
  • The menstrual cycle comes back when the level of prolactin decreases, menstruation may occur irregularly until the level of hormones stabilizes.
  • The body’s reaction to the breastfeeding process is different for each woman. In some women, menstruation can resume within a few weeks, for others many months can pass, even up to 9-12 (lactational amenorrhea).
  • For many women, menstruation returns only after the child has been weaned and no longer drinks at the breast. For many women, this often leads to the fear that they will no longer get menstruation in the future and that they will no longer be fertile.
  • It is necessary to know that in a woman who has an irregular cycle, ovulation does not occur at all. For this reason, it is important to take precautions if you do not want to get pregnant again immediately.

How to have regular menstruation during breastfeeding?

  • Premature or delayed menstruation can be a cause for concern.
    Physical and mental stress can affect the monthly cycle. If the child sleeps more than four hours a day and more than six hours at night, a regular cycle is more likely to occur.
  • In addition, if the child begins to consume solid foods as well (weaning phase) and is not breastfed day and night (every 4-6 hours), menstruation will return earlier than if children are still drinking at the breast.

Ecological breastfeeding The greatest effect of breastfeeding on the menstrual cycle and fertility is observed in women who practice breastfeeding ecologically.
As Sheila Kippley explains in her book Breastfeeding and Natural Child Spacing, the 7 principles of ecological breastfeeding are:

  1. Exclusive breastfeeding (the child should not be given any other liquids or solid foods from other sources) in the first six months of life.
  2. Place the child on the chest in a comfortable position.
  3. Do not use bottles or pacifiers.
  4. Take a nap with the child during daily breastfeeding.
  5. Breastfeed the child more often during the day and at night, without fixed times.
  6. Sleeping in the same bed with the child at night to breastfeed him.
  7. Avoid any practice that leads to separation from the child.

Many mothers who follow Kippley’s principles of ecological breastfeeding do not menstruate for over 14 months.

In women who do not exclusively breastfeed (or do not follow all recommendations on ecological breastfeeding), there may be a delay in the return of the cycle, but usually for a shorter period of time than in mothers who breastfeed ecologically.

The return of menstruation depends on several factors:

  1. how often the child is breastfed;
  2. how often the child is fed with the area;
  3. from when the baby starts using a pacifier;
  4. how long the child sleeps at night;
  5. how much solid food the child absorbs;
  6. the chemistry of the maternal body;
  7. the way in which the woman reacts to the hormonal influences associated with breastfeeding.

Every time the stimulation of the breast decreases, especially at night, it is likely that menstruation will return.

Can you get pregnant while breastfeeding?
How can you know if you are pregnant if you have irregular or completely absent (amenorrhea) menstruation? Can you still get pregnant? Yes.
It’s a misconception to think that you can’t get pregnant while you’re breastfeeding. In most women, fertility decreases during breastfeeding, but persists.
There is no rule to know when to take a pregnancy test, but if there are doubts, it is better to do the test.

Irregular menstruation after the postpartum period (pregnancy)

  • Menstruations after the puerperium are the first menstruations after the birth of the child.
    It is not uncommon for irregular menstruation to occur after childbirth.
    Some women may menstruate in the first ten weeks after giving birth, but the return of the cycle can be delayed by 5-6 months or even a year.
    Women may have an irregular cycle for a few months.
    During this period, menorrhagia (heavy bleeding) may occur.
  • In addition, it is common for menstruations to be irregular for many months after their return and/or the blood flow is much stronger than normal.
    If there are no polyps or fibroids, long-lasting menstruation with heavy blood flow is due to the inability of the uterus to contract effectively. The cause is dilation, which has arisen as a result of pregnancy. The problem improves over time when the uterus returns to its normal size.

Bleeding after childbirth The bleeding that occurs after childbirth
is called postpartum flow (lochia).
It is fragments of the endometrium that are released when the size of the uterus decreases.

The bleeding after childbirth is bright red for the first few days and then turns pink or brownish in the following weeks.
After two weeks, the bleeding changes to a yellowish or cream-colored discharge over the following five weeks. This is not menstrual blood.

Irregular menstruation in adolescence

Usually, irregular cycles are part of a normal change that can occur in healthy girls up to the age of 15 or 16.
Often the cycle duration is longer and 3 months can pass between two menstrual phases.
Over time, the cycle will most likely stabilize. This usually happens three years after menarche (first menstrual period).

Causes of irregular menstruation in adolescence

Some girls may have irregular menstrual cycles due to:

  • certain medications,
  • intense sports (menstruation is weak or absent),
  • low or excessive body weight. The adipose tissue functions like a gland and converts androgens into estrogens. These hormones inhibit in the pituitary gland (a gland that controls the hormones in the body) the production of gonadotropins (FSH, LH and hCG), which are fundamental for ovarian activity.

Other girls may have problems as a result of hormone fluctuations.
For example, thyroid disease can lead to irregular menstruation if the concentration of thyroid hormones in the blood is too low or too high.

Some women have irregular menstrual cycles because their bodies produce too many androgens. These are hormones that, in excess, can cause:

  • the growth of facial hair,
  • excessive increase in muscle mass,
  • a more masculine voice,
  • growth of pubic hair,
  • Increase in height in girls.

When to worry?
If these signs occur or if the cycles are irregular for at least 3 years, one should consult a doctor.
Dark blood is not a cause for concern, because it could be older blood that has remained in the uterus for a longer period of time. The cause could be an excessively narrowed cervix on the cervix.

Irregular menstruation during menopause

Irregular cycles
Often, irregular menstruation is the first sign of pre-menopause. Although the exact symptoms of irregular menstrual cycles vary, most women have irregular menstruation for over three to ten years before they disappear completely.

Female hormone levels change as menopause approaches.
Irregular menstruation occurs due to the fact that the female cycle is fully dependent on hormones.
These irregularities can be aggravated by other gynecological problems that often occur in middle age. For example, growths can develop in the uterus, such as:

  • Adenoids
  • or fibromas.

The decline in fertility is another sign of pre-menopause, which is accompanied by irregular cycles and can become an emotionally stressful problem for women who still want to have children.

Causes of irregular menstruation during menopause

Menstrual bleeding can occur very irregularly as menopause approaches (premenopause).
Menopause occurs when 12 months have passed since the last menstrual cycle.
Pregnancy is the most common cause of absence of menstruation (amenorrhea).

You have to be careful, because women can also maintain fertility up to 54-55 years.
A pregnancy test helps to find out if a woman is pregnant.
If the woman is not pregnant, there may be the following causes of absent or irregular menstruation:

  • Sharp loss or increase in body weight. Even though low body weight is a common cause of missed or irregular menstruation, being overweight can also lead to menstrual disorders.
  • Eating disorders such as anorexia nervosa or bulimia.
  • Excessive exercise. Amenorrhea is common in high-performance female athletes.
  • Emotional stress.
  • Diseases.
  • Travel.
  • medications, such as birth control pills, which can cause lighter, rarer, more frequent or completely absent cycles; After stopping the pill, a cycle can easily fail or some fluctuations in cycle duration can occur.
  • hormonal imbalances; they can lead to changes in the hormone levels that the body needs to maintain menstruation.
  • Drug abuse.
  • Diseases of the pelvic organs such as:
    • hymen imperforatus (virginity),
    • polycystic ovary syndrome,
    • Asherman’s syndrome.

It is worth remembering that you can also get pregnant if menstruation occurs irregularly. If there is no desire to have children, contraceptive methods must be used.

Premature ovarian failure occurs when:

  • menstruation is completely absent (primary amenorrhea)
  • stop before the age of 40 (secondary amenorrhea).

In some cases, premature ovarian failure is caused by an autoimmune disease.
In other cases, it is the result of surgery, chemotherapy and radiotherapy of the abdomen or pelvis, which can cause premature ovarian failure.

Other causes of irregular menstruation

Other conditions can cause amenorrhea or irregular menstrual cycles, although this is rare:

  • Tuberculosis
  • liver diseases (for example, cirrhosis),
  • Diabetes mellitus.

If one of these conditions is present, there are usually other symptoms in addition to irregular menstruation.
If a cycle is skipped, you should keep calm.
Restoring emotional and physical balance can be helpful.
Many women don’t menstruate every now and then. If they are not pregnant, there is a high probability that the cycle will return the following month.

Other possible causes of irregular menstruation:

  • Uterine cancer or cervical cancer.
  • hormonal imbalances; in the case of very short cycles (even 2 times a month), the cause is usually an abnormal hormone level.
  • Pharmaceuticals such as corticosteroids or anticoagulants (anticoagulants).
  • Iron deficiency anemia, other disorders of blood clotting.
  • Thyroid diseases such as hypothyroidism and hyperthyroidism or pituitary diseases that affect hormonal balance.
  • Complications associated with pregnancy, including spontaneous abortion or ectopic pregnancy (the fertilized egg implants outside the uterus, for example, in the fallopian tube).

How are irregular menstruations treated naturally?

Some tips and remedies for self-help:

  • Try to maintain a healthy lifestyle with moderate exercise.
  • If you need to lose weight, it is better to do it gradually, instead of following diets that drastically limit calorie and nutrient intake.
  • Rest sufficiently.
  • practice techniques that relieve stress and relax;
  • Female athletes should reduce excessive and extended daily exercise. Excessive exercise can cause irregular cycles.
  • Change tampons or hygienic pads several times a day to prevent toxic shock syndrome (TSS) and infection.
  • Herbal products can help regulate the monthly cycle:
    • Calendula
    • Raspberry
    • Chaste tree.

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