Irregular menstrual periods are assessed in women with cycles that are shorter than 21 days or longer than 35 days. If menstrual bleeding is heavy, prolonged or if there is spotting between 2 menstrual periods, a doctor should be consulted. Periodic changes that affect the entire body, especially the genital system, and are characterized by hormonal changes and menstrual bleeding that recur every month from the first menstrual period to menopause are defined as the menstrual cycle. The first day of menstrual bleeding is the beginning of the menstrual cycle. This period lasts approximately 28 days. It is considered normal for menstrual periods to be irregular in the 12-18 months following the first menstrual period. There are 4 factors that constitute a normal menstrual period. These are;
Hypothalamus
Pituitary
Ovarian
Uterus
If any of these factors cause a problem, menstrual irregularity will occur.
What are menstrual cycle disorders?
Oligamenorrhea: Irregular bleeding lasting longer than 35 days.
Polymenorrhea: These are irregular bleeding that occurs at intervals of less than 21 days.
Hypomenorrhea: This is the lesser amount of bleeding during menstrual period.
Hypermenorrhea: Menstrual bleeding is heavy in quantity but of normal duration.
Menorrhagia: Prolonged menstrual bleeding.
Metrorrhagia: This is bleeding that occurs at irregular intervals.
Menometrorrhagia: This is heavy bleeding that occurs at irregular intervals.
Ovulation bleeding: This is light bleeding that occurs between the 2 menstrual bleedings.
Premenstrual bleeding: This is light bleeding that occurs before the 2 menstrual periods.
Spotting: These are bleedings that occur in the form of spotting. They usually occur due to an intrauterine device or hormonal disorder.
Juvenile bleeding: This is bleeding that occurs at or after menarche and is usually due to ovulation problems.
Menstrual irregularity can be caused by hormonal changes, ovarian cysts, endometrial hyperplasia, which is excessive growth in the lining of the uterus, polyps in the uterus or cervix, myomas and rarely uterine cancer. Abnormal menstrual bleeding can be based on an organic cause, or it can occur as dysfunctional uterine bleeding. Menstrual irregularity usually occurs as dysfunctional bleeding. In these bleedings, there may be differences in the amount or duration of menstruation.
What is the reason for period delay?
In women, menstrual delays can be quite common during the fertile period. In a healthy woman who has an active sexual life, this may be due to pregnancy. Another reason for the delay is the lack of ovulation during the cycle. In addition, in women who have regular menstrual periods, unexpected menstrual delays may occur due to stress , spatial changes or the effects of the seasons. It is normal to have a period delay of 1-2 times a year. However, if menstrual delays continue for a long time, hormone levels in women should be evaluated. Women using birth control pills to prevent pregnancy may also cause a period delay.
How are menstrual irregularities in women treated?
In order to be treated, the factor causing menstrual irregularity must be determined. Therefore, the woman should undergo a gynecological examination and the factor causing menstrual irregularity must be determined. Factors such as myomas, polyps, and ovarian cysts in the uterus or cervix can be detected as a result of the examinations. When hormonal effects are detected after an ultrasound examination and vaginal smear test performed on women, treatment is started. When the factor causing menstrual irregularity is eliminated, menstrual bleeding will become regular on its own. While drug treatment is applied for some of the reasons causing this, surgical interventions are applied for some reasons. In order to determine menstrual irregularity, women should follow their menstrual regularity starting from puberty. This allows menstrual irregularity to be treated early. Thus, treatment becomes easier. When menstrual bleeding is excessive, bleeding-stopping and blood clotting disorders should be evaluated in women.
What causes short-term menstrual bleeding?
Hypomenorrhea is defined as the amount of bleeding or the number of days during menstruation. The main reasons for this are the increasing age of the woman and the use of birth control pills. In addition, Aserman syndrome, which is a complication of abortion, or adhesions in the uterus, can be one of the factors that reduce bleeding during menstruation. In addition, low-volume menstrual bleeding in sexually active women should suggest pregnancy.
Why does prolonged menstruation occur?
The increase in the amount of bleeding or the day during menstruation is defined as hypermenorrhea and menorrhagia. Women lose 20-60 ml of blood during a normal menstrual period and the bleeding lasts for 2-6 days. The most important factor that regulates the amount of bleeding is the ability of the uterine muscles to contract. In addition, the progesterone hormone produced by ovulation in the middle of the menstrual period remains at certain levels, which ensures that menstrual bleeding is at a certain level. When these mechanisms are disrupted, bleeding is more than normal and lasts longer. In cases of myomas that occur as a result of thickening of the uterine muscles or thickening of the uterine wall, the ability of the muscles to contract is negatively affected, prolonging the bleeding period and increasing the amount of bleeding. In sexually active women of reproductive age, the possibility of an unplanned pregnancy resulting in miscarriage should be evaluated in cases of excessive bleeding that begins after a delay in menstruation. Infections occurring in the uterus can also cause prolonged menstrual bleeding. Intrauterine devices also disrupt the ability of the uterus to contract and may cause an increase in the amount of menstrual bleeding. Apart from this, monthly contraceptive injections, implanon, and plastic ovary syndrome can also cause excessive menstrual bleeding.
What causes abnormal menstrual bleeding in young girls?
Gynecological problems in young girls during puberty are similar to those seen in adulthood. These abnormal and excessive bleedings during the developmental period are defined as juvenile bleeding. These may be due to hormonal disorders or may develop due to irregular functioning of hormones. There is usually no egg formation in the ovaries or there is irregular ovulation. The most common cause of this is a secretion defect in the progesterone hormone. Intense bleeding can sometimes continue for several weeks. In order to treat it, the missing hormone in the body must be replaced. Therefore, birth control pills, which are effective in controlling sudden and excessive bleeding, can be used. However, excessive use of hormones in young girls who are growing during this period can stop growth or cause abnormalities. Therefore, caution should be exercised in the use of hormone medications. Although formations such as myoma , cyst, and polyp in the uterus are investigated because this is a period when young girls are not sexually active, only observation can be made since methods such as curettage cannot be used. Although ovulation may improve on its own, young girls experiencing this problem should be closely monitored because they are prone to developing polycystic ovary syndrome in the future and have a high probability of experiencing fertility problems.
What causes bleeding between periods?
The most common cause of intermenstrual bleeding outside of menstrual bleeding is infections in the cervix and the inner lining of the uterus. The most common cause of these infections is bacteria called ureoplasma and chlamydia, which are transmitted through sexual contact. In addition, hormonal irregularities, polyps, myomas, injuries to the genital organs, some medications used, and endrometriosis disease. In addition, since the intrauterine devices used to prevent pregnancy irritate the inner lining of the uterus, low-dose birth control pills, protection injections, and the implant cause hormonal imbalance, they can cause bleeding in the form of spotting. Although rare, precancerous lesions in the cervix, cervical cancers, and genital cancers can have the effect of intermenstrual bleeding. Therefore, intermenstrual bleeding in women should be taken seriously. Their treatment is applied according to the cause of the bleeding. If left untreated, anemia caused by blood loss, infertility due to the cause, and cancer may develop. In treatment, the use of hormone preparations, which mostly contain progesterone, is effective in preventing intermenstrual bleeding.
What should be done in case of irregular menstrual bleeding during the menopause transition period?
Women see their menstrual cycles regularly during the fertile period due to regular ovulation every month. When menopause is approaching, due to the decrease in the number and quality of egg cells in the ovaries, menstrual cycles gradually increase and ovulation does not occur frequently. Sometimes, it can be seen that the level of progesterone hormone produced due to low egg quality is not sufficient. These factors manifest themselves as menstrual irregularity in women. Therefore, the symptoms of hormonal disorders seen during the menopause transition are very important. In women in menopause , menstruation may be delayed, menstruation may not occur with the delay, menstruation may become rare, menstruation may occur at an unexpected time as a result of the delay, or the duration of menstruation may be prolonged and the amount may increase. Menstrual irregularities seen during menopause may be due to an organic cause. Therefore, women in menopause should have regular gynecological examinations every 6 months and should be evaluated by ultrasound examination.
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