As women, we tend to ignore our own health needs. One of the health problems that we face but ignore, is irregular periods. These can happen for a lot of reasons. In this article, Dr. Ankita Kaushal in a free-flowing conversation with Dr. Renuka Dangare talks about irregular periods.
Understanding irregular periods: A gynaecologist weighs in.
Dr. Ankita Kaushal is a gynaecologist, fertility specialist and IVF specialist. She’s also an adolescent health expert and a sustainable menstruation expert! She’s based in Navi Mumbai and has her own practice. You can follow her on @drankitasfertilitycentre on Instagram.
Before we start, let’s understand what menstruation and the menstrual cycle actually are.
What is menstruation?
Menstruation is a woman’s monthly bleeding, often called your “period.” When we menstruate, our body discards the monthly build-up of the lining of your uterus (womb). Menstrual blood and tissue flow from your uterus through the small opening in your cervix and pass out of your body through your vagina.
During the monthly menstrual cycle, the uterus lining builds up to prepare for pregnancy. If you do not get pregnant, estrogen and progesterone hormone levels begin falling. Very low levels of estrogen and progesterone tell your body to begin menstruation.
What is a menstrual cycle?
The menstrual cycle is the monthly hormonal cycle a woman’s body goes through to prepare for pregnancy. Your menstrual cycle is counted from the first day of your period up to the first day of your next period. Your hormone levels (estrogen and progesterone) usually undergo ups and downs throughout the menstrual cycle.
What do we mean by Irregular Periods?
To understand irregular periods, we need to have a reference point where we understand what is normal only then we can say something is off normal.
Explaining what a regular period is, Dr. Ankita Kaushal said, “Regular Periods are a monthly occurence. The range between two periods should be anywhere between 21 days to 31 days. It can also be extended to an upper limit of 35 days. So, one part of the definition is the interval. The second part of the definition is bleeding. The duration of bleeding can be from 2 days of bleeding up to 7 days of bleeding.
A lot of people these days are using sanitary napkins, menstrual cups, or tampons. So as far as the bleeding is concerned, you’re using 4-5 sanitary napkins every day for the day of your heavy flow and 2-3 sanitary napkins the days you have low flow. This sums up what a regular period is.
The commonly observed presentation of irregular periods in today’s female population is delayed. It’s important to understand that irregular periods can happen at any age. So, we have very young girls who are teenagers, then there is a bracket of 25-35 and then there is a bracket of 45 and above. The reasons for irregular periods in these 3 age groups are different.
Common Causes of Irregular Periods
Irregular periods: Sometimes, a woman’s period is delayed by 40-45 days. An irregular period is a symptom that is indicative of an imbalance inside the body which is not letting your body maintain regularity as it should. On and off you have been experiencing an irregular period. It could be every period; it could be every third or fourth month the period becomes irregular or it could be someone who had very regular periods and suddenly during the past 3 months or 6 months, you’re experiencing irregular periods.
Speaking of causes, the first and most common cause of irregular periods in every menstruating woman is pregnancy. If you’re sexually active and have missed your periods you have to check for pregnancy. It doesn’t matter if you’re practicing good active contraception.
Thyroid abnormality: The second common cause is Thyroid abnormality. The thyroid controls a lot of things in the body mainly metabolism, our hot and cold temperature perception, and also our menstrual cycles. The most common abnormality that we find is a deficiency in thyroid hormones or hypothyroidism.
Cyst: Cyst is a water-filled balloon. Ovaries have small follicles that contain the egg. This rupture every 14th day of our period. Now there could be a situation where due to some odd reason this balloon which was harbouring a good egg didn’t rupture because of some temporary hormonal imbalance. It couldn’t release the egg and it became a cyst.
Prolactin hormonal imbalance: Our body produces a hormone called prolactin. Whenever the mother is breastfeeding it’s the prolactin hormone that comes into play. Whenever there is a sudden change in sleep pattern, if the prolactin shoots up it can also cause irregular periods. There is also another hormone known as cortisol. High levels of cortisol can also cause problems. Cortisol is also known as the stress hormone.
Polycystic ovary syndrome (PCOS): PCOS is the most common reason for irregular menses of the reproductive age group.
Breastfeeding: When you’re breastfeeding that is the time the periods will be irregular or completely absent. The hormones that come into play in breastfeeding prevent ovulation and hence it is completely normal for new mothers to not get their periods in the first 3-6 months after childbirth and even longer in some cases.
Lifestyle causes of irregular periods
Exercise Regime: If you exercise too much it’s going to alter the corticosteroid levels in your body. Corticosteroid is a kick-starter of your day which in turn is going to affect your thyroid levels and metabolism of your body. All this is going to affect the reproductive hypothalamic adrenal ovarian axis. Once that hormonal axis gets disturbed temporarily your periods will be irregular. If you have suddenly started exercising then the cause of your periods could be exercise. You’re adopting an exercise regime for a healthier and fit body and if it’s going to make you unhealthy, then it’s time to change. If your exercise is a high-intensity form of physical activity which is not suited to your body, your body is unable to cope up, your periods may become irregular.
Binge-eating disorders: With bulimia and binge-eating disorders, the high volume of food intake in such a short period, the sugar level spikes in the body. You’ve eaten 4-5 packets of your favorite chips, and you purge all that out. So, there’s going to be a sharp drop in sugar levels and insulin levels. These erratic blood sugar levels are responsible for a hormonal imbalance and hence, irregular periods.
Anorexia Nervosa: Anorexia Nervosa is when it’s fixed in a girl’s mind that even if she eats a little portion of food she is going to put on weight. It is at a more psychological level than at a physical level. In anorexia nervosa because of major energy deficiency, there is no ovulation and hence, there are no periods.
Each woman experiences their periods differently. When getting irregular periods, you must talk to your physician and discuss your concerns. To know more about menstrual health, visit us at https://www.proactiveforher.com/
This blog has been transcribed from a webinar titled ‘Irregular Periods with Dr. Ankita Kaushal’.
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