Any woman can feel a great deal of anxiety when experiencing irregular periods. However, several women have been affected by it and have become a common problem of women these days. If a woman misses her period, it can be a sign of pregnancy, but having irregular periods may also indicate some issues associated with fertility. Around 30-34 percent of women experience irregular periods and fertility issues. A woman who continues to experience anovulation, wherein there is no oocyte released every month, has an increased risk of infertility.
It can become difficult to get pregnant if a woman continues to have irregular menstrual cycles. However, fertility drugs can treat anovulation in women. Other conditions such as thyroid, pituitary, and adrenal gland abnormalities that interfere with ovulation need to be ruled out first. For further assessment, your healthcare provider will refer you to a specialist after the initial screening.
An irregular menstrual cycle happens when the cycle is less than 21 days, more than 35 days, or in between extremes. The common causes of irregular periods include:
Other causes could be:
- High prolactin levels in breastfeeding women
- Thyroid problems
In women with irregular periods, the main problem is that they are not ovulating during the cycle or not releasing a mature egg. The menstrual cycle has two phases. The first one is the follicular phase, which lasts for 14 days, which begins from the day you get your period until ovulation. Three things happen during this phase:
- The egg follicle starts to mature in the ovary.
- The lining of the uterus becomes thick and ready for implantation of the fertilized egg.
- On the 14th day, elevated levels of estrogen cause a surge of the luteinizing hormone (LH) leading to ovulation.
The luteal phase begins after ovulation. This phase also lasts for 14 days. In this phase, the levels of progesterone and estradiol are high. These two hormones maintain the uterine lining for implantation. However, if there is no implantation, then the levels of the hormones fall and the lining of the uterus is shed through the process of menstruation.
Signs of Irregular Periods
- Variation in cycle length
- Missing periods without pregnancy
- Early or late periods
- Getting periods in less than 20 days
- Bleeding for longer than 8 days
Causes of Irregular Periods and Infertility
Stress is one of the major causes of irregular periods. The stress hormone called cortisol directly affects the levels of estrogen and progesterone. Thus, the flow of a woman's menstrual cycle may vary. Another factor that affects the menstrual cycle is one's diet. The level of hormones changes due to unhealthy eating habits. Other factors that cause abnormal periods are:
- Hormonal Problems - Women may not be able to menstruate if their hormones are out of balance. However, there could be many possible reasons for a hormonal imbalance.
- Polycystic Ovarian Syndrome (PCOS) - If the levels of estrogen and progesterone are unbalanced, then it is possible for ovarian cysts to develop. In PCOS, women have fewer than nine periods a year while some do not have periods at all.
- Premature Ovarian Failure - If the ovaries stop functioning before the age of 40, women may be diagnosed with premature ovarian failure. In this condition, women may have infrequent periods. The signs of this condition and menopause are quite similar.
- Unhealthy Eating - A woman may notice fewer and lighter periods if she has eating disorders such as anorexia or bulimia. Some women with eating disorders may not get their periods at all. Women may experience hormonal changes if they have eating disorders, and these hormonal changes may cause menstrual changes. Abnormal periods may be also caused by unintentional weight loss or weight gain.
- Medications - Consult your doctor if you are taking certain medications and having irregular periods. Taking birth control pills can cause more frequent or lesser and lighter periods.
- Stress - The body may be negatively affected in many ways by anxiety and chronic stress. Hence, women’s periods may be affected by their emotional health. Hormonal changes due to stress may cause women to miss their periods. If stress hormones are high in women, they may stop ovulating. Women who have demanding and stressful jobs are more prone to experiencing irregular periods.
Polycystic Ovary Syndrome (PCOS)
About 5-10 percent of women in their reproductive years are affected by the common ovulation problem called polycystic ovary syndrome (PCOS). In this condition, there is a hormonal imbalance with an abnormal ovarian function, wherein there is an enlargement of the ovary due to the presence of fluid-filled cysts.
Symptoms of PCOS
- Irregular periods or no periods
- Irregular ovulation or no ovulation
- Resistance to insulin
- Weight gain
- High blood pressure
- Oily skin, acne
- Hair becomes thin or shows male pattern of baldness
- On the body and face excess growth of hair
- High blood pressure
- Abnormal level of cholesterol and triglyceride level is high
Fertility Problems with PCOS
In PCOS, one way of increasing the chances of pregnancy is by losing weight. To lower the levels of insulin, the doctor might prescribe medications. A common problem in women with PCOS is that there is an increased insulin level in the body since the body is unable to recognize its own insulin. Such state chronically increases insulin levels and can cause diabetes. There is an increased risk of developing type 2 diabetes, heart disease, and endometrial cancer in women with PCOS, especially if the condition is left untreated.
There is no cure for PCOS, but its symptoms can be treated. Moreover, infertility due to PCOS can also be treated. In women trying to conceive, it is possible to stimulate ovulation and treat insulin resistance. Treatment will help restore ovulation and help women get their regular periods again.
For women with PCOS, another potential treatment is in vitro fertilization (IVF).
As previously mentioned, stress can contribute to ovulation problems. Stress tends to increase in women who keep on trying to conceive for a longer period of time without success. The fear of infertility may also influence a woman's chances of pregnancy. To relieve stress, you can try joining support groups and seek medical intervention by talking to a therapist who will help you cope with your stress and anxiousness.
Tips to Reduce Stress
- Have an open communication with your spouse.
- Try couples counseling, join support groups, talk to a therapist, and read books.
- Try meditation techniques such as yoga and meditation.
- Find time to exercise to release physical and emotional tension.
- Avoid or cut down on caffeine.
- Learn more about the causes of infertility and available treatment options.
To stimulate ovulation, your doctor may prescribe fertility drugs. Clomifene is often the first drug of choice. It has been used for decades and it is very effective. The drug works by increasing the production of eggs. It is used to correct irregular ovulation and to induce ovulation. The drug is often used in women with anovulation. However, the disadvantage is that this drug makes the cervical mucus hostile by preventing the sperm from entering inside the uterus. However, this problem is solved through artificial insemination.
Doctors may suggest other fertility drugs depending on your situation. Fertility drugs stimulate the development of follicles and eggs in the ovaries. These drugs are also known as superovulation drugs. They are usually administered through skin injections. The doctor needs to monitor the condition of the patient since some of these drugs may overstimulate the ovaries and may cause abdominal discomfort and bloating. Monitoring needs to be done through a vaginal ultrasound. The estrogen levels are also checked and monitored. With the help of these drugs, almost 90 percent of women are able to ovulate and 60 percent of them are able to become pregnant.
To maintain the cycle, the natural process of hormone regulation can be improved by making slight changes in food eating habits, lifestyle, and weight management.
Menstruation and Ovulation
The key to conceiving is ovulation. Without the release of a mature egg, it is impossible to get pregnant. Having periods does not mean that you are ovulating. Even without ovulation, the body may shed the uterus lining. According to studies, women are unlikely to ovulate in their cycle if their cycle is shorter than 21 days or longer than 35 days.
Fertility is affected even in women who are ovulating with irregular periods. It can become hard for the couples to predict when the egg is released if the cycle is too long.
- Document and keep track of the length of your cycle.
- To determine whether you are ovulating or not, you can consider taking and recording your basal body temperature.
- Use a urine-based ovulation predictor kit. First, calculate the average length of your cycle and then subtract 14 days. This will help you find your ovulation day. Use the OPKs two days prior the predicted ovulation day.
- See a gynecologist or a reproductive endocrinologist if you are unable to determine when you are ovulating, if you are concerned about PCOS, if you have been trying to get pregnant for several months, or if you have other medical problems. The doctor can determine whether you are ovulating or not by doing blood tests and using ultrasound.
- For women with PCOS and who are not able to ovulate, an ovulation induction treatment is available.
- Alternative treatments that some women with irregular periods choose in conjunction with traditional medical treatment is acupuncture. However, the benefits are still not been proven by clinical trials. In case of women affected by stress, they can get a calming effect by acupuncture.
Irregular Periods and Fertility
Usually, a woman gets 11-13 periods a year, and represent chances of pregnancy. The chance of getting pregnant reduces if you have lesser periods. Even for healthy women, getting pregnant is not that easy. It has been recommended by doctors that women with regular periods should try a full year before going to fertility clinics.
Conceiving will take longer if you do not ovulate every month. Many women use fertility planning when trying to conceive. This is to determine the fertility window. It means to determine the days when they are likely to get pregnant. If a woman has a regular cycle, then it is easy to plan and every month prediction can be done. However, if the cycle is abnormal, then it becomes difficult to determine the fertility window.
How to conceive?
- If a woman has irregular periods, it does not mean that it is impossible to get pregnant.
- Make appointments with the doctor. You will be tested for the causes of anovulation such as thyroid problems and other abnormalities.
- The doctor will determine the cause and the possible solution.
- The doctor may recommend certain lifestyle changes.
- The doctor may refer you to a dietitian to lose weight or gain weight.
- Medications may be prescribed depending on your condition.
- In PCOS, the doctor may suggest decreasing insulin levels.
- In anovulation, the doctor may recommend fertility drugs such as Clomid or clomiphene.
- After following the advice of the doctor to increase the changes of getting pregnant, you can take vitamins, get rid of bad habits, avoid pesticides, and follow fertility boosting tips.