Also known as anovulatory bleeding or abnormal vaginal bleeding outside of normal menstrual cycles regulated by hormones. This condition occurs in varying degrees, sometimes only as spotting on underwear or changes in cycle length.
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The normal monthly menstrual cycle is initiated by the shedding of the uterine lining, which grows thicker each month in preparation for a potential pregnancy.
If ovulation does not occur, the menstrual cycle may be delayed, causing the uterine lining to thicken further, which can explain why delayed periods often have a heavier flow.
Light menstrual bleeding may sometimes occur in the middle of a regular cycle and can be attributed to an unstable uterine lining, insufficient hormone levels, or excessive thickness of the lining.
Other factors that can alter the pattern of bleeding include:
– Certain abnormal endocrine disorders.
– The influence of certain medications.
– Overexertion in sports or weight loss.
– Stress or certain illnesses.
– Early onset of menstruation at a young age.
– Perimenopause: Abnormal bleeding can occur in the final months leading up to menopause.
Diagnostic Symptoms
This irregular bleeding condition occurs intermittently, varying from month to month and lasting for differing durations depending on the individual. The amount of blood can be little or significant, sometimes accompanied by clots. Various tests can be conducted to rule out several causes of abnormal bleeding.
Pregnancy: Urine and blood tests.
Thyroid hormones or prolactin: Blood tests.
Menopause in women aged 40 or 50: Blood tests to determine declining estrogen levels.
Uterine or ovarian abnormalities: Transvaginal ultrasound can measure the thickness of the uterine lining.
There may be a risk of cancer in women over 35 or those with a family history of breast, ovarian, or colorectal cancer, or those who have not had a period for over six months.
Endometrial biopsy can also be performed in a clinic using a speculum to assess the condition of the cervix.
Most women with irregular periods or varying blood flow during a normal cycle are likely experiencing anovulation.
Some women may return to regular cycles through the use of contraceptive pills.
If this irregularity is a sign of early menopause, it typically lasts only a few months.
Treatment Methods
If the cause of the bleeding is due to another medical factor, treating that condition will restore regular menstrual cycles.
Contraceptive pills, typically containing a combination of estrogen and progesterone, can help regulate and reduce bleeding. Long-term use of progestin-only pills may be recommended.
Severe bleeding can still be controlled with high doses of hormones, either estrogen or progesterone. If bleeding worsens, hospitalization may be necessary.
If hormonal treatments are ineffective, cervical dilation and curettage may be required.
If a biopsy reveals endometrial hyperplasia, treatment and monitoring may be necessary, especially in older women or those post-menopause using hormone replacement therapy, as endometrial hyperplasia increases the risk of uterine cancer.
When to Seek Emergency Care
Seek immediate attention if experiencing fever, dizziness, fainting, abdominal pain, or heavy bleeding.
Even if irregular periods are mild, it is important to inform your doctor.
There are many effective treatment methods to restore menstrual regulation or manage abnormal bleeding symptoms. If you find that irregular periods are making it difficult to conceive, treatment may help stimulate ovulation. Irregular menstrual cycles do not necessarily mean you will be infertile, so continue to use contraception if you are still sexually active.
