Menstrual bleeding varies in duration and severity from woman to woman. A menstrual cycle is defined as the time between the first day of one period and the first day of the next. The average menstrual cycle lasts 28 days, but also varies from person to person and month to month. If your periods occur every 21 to 35 days, they are considered regular. Blood flow lasts four to five days on average, with a blood loss of approximately 2-3 tablespoons per day, and an average of 80 ml during periods.
Your periods may be irregular when you are in the first two years of menarche, the first menstrual bleeding. This is completely normal, but in case it is the same after that period, you may need to rule out certain causes of irregular periods, Dr Nimmi Mahajan, lead gynaecologist, Proactive for Her, told indianexpress.com.
She noted that if the length of your menstrual cycle varies, you have irregular periods. “Your periods can be early or late or even skip some months. Many women develop a regular cycle after puberty; it can occur anytime between the 21- 35th day of your menstrual cycle. If you can’t predict your periods and also have a heavy flow when you have it, you likely have irregular periods.”
She also points the following as symptoms of irregular periods:
- Periods that skip days or months
- Spotting between periods
- No periods
- Heavy cramping during periods
What causes heavy or irregular menstrual periods?
Dr Mahajan said that heavy or irregular periods may be a result of:
- Hormonal imbalance: The hormones oestrogen and progesterone control the formation of the uterine lining. An increase in these hormones can result in heavy bleeding. Hormone imbalances are most common in girls who started menstruating within the last year and a half. They are also common in women approaching menopause.
- Some medical/gynaecological conditions: Thyroid problems, PID (Pelvic inflammatory disease), endometriosis, and an inherited blood disorder can all cause irregular periods. Endometriosis is a condition in which the tissue that lines the inside of the uterus grows elsewhere in the body. This can result in severe bleeding as well as pain. An inherited blood disorder is one that affects clotting.
- Benign growths or cancers: Heavy bleeding can be caused by cervical, ovarian, or uterine cancer, but these conditions are uncommon. Uterine benign, or noncancerous, tumours can cause heavy bleeding or long periods. When the growth is made up of endometrial tissue, it is referred to as a polyp and those made of muscle tissues are called fibroids.
- Lack of ovulation: Anovulation results in insufficient levels of progesterone hormone, which leads to heavy periods.
- Adenomyosis: The glands of the uterine lining embed in uterine muscle resulting in heavy bleeding which is known as adenomyosis.
- Medication: Menstrual bleeding can be affected by anti-inflammatory medications, anticoagulants, or hormone medications. Heavy bleeding can be a side effect of intrauterine devices (IUDs), which are used to prevent pregnancy.
If your doctor suspects irregular periods, they may ask you to take an ultrasound of the uterus, pap smear or blood tests to arrive at the cause of this irregularity.
When should you seek medical care?
Dr Mahajan advised seeing a doctor if you have periods for more than 7 days, require more than one tampon/pad/cup in an hour, have severe pain/ fever or if you have abnormal discharge or odour in the vagina. “Additionally, you can seek medical help if you have sudden weight loss or gain, have extra hair growth on the body, get new acne, excessive and resistant kind, and if you see any nipple discharge,” she adds.
What are the available treatment options?
The treatment will be determined by your overall health, the cause of menstrual irregularities, and your reproductive history. Any underlying medical conditions, such as thyroid dysfunction, must also be addressed. You can also include some lifestyle changes to aid in fixing the length of your cycle, suggested Dr Mahajan.
Yoga has been considered to be an effective treatment for a variety of menstrual problems. It has also been shown to reduce menstrual pain and emotional symptoms related to menstruation, such as premenstrual syndrome (PMS), as well as improve the quality of life in women with primary dysmenorrhea (menstrual cramps).
Maintain a healthy weight
Extreme weight loss can cause irregular menstruation. Additionally, menstruating people who have gained weight are likely to have irregular periods, heavier bleeding, and pain because fat cells affect hormones and insulin. Consult your doctor if you want to lose weight. They can help decide a target weight and develop a plan to reach it.
Find time to exercise
Exercise has numerous health benefits that can help with your menstrual cycle. It can help you achieve or maintain a healthy weight and is frequently prescribed as part of a treatment plan for polycystic ovary syndrome (PCOS) which can also cause menstrual irregularities.
Eat a balanced diet
Include fresh fruits, seasonal vegetables and fibre rich foods in your diet. Get the help of a nutritionist to help you draft a diet suitable for your body needs.
Vitamin B and Vitamin D
Low levels of vitamin D may be observed in women with irregular periods and taking vitamin D supplements may help regulate menstruation. You may take vitamin D fortified or cereal and spend some time in the morning sun. Vitamin B may lower the intensity of your premenstrual symptoms. Eggs, milk and legumes are good sources of Vitamin B.