What is oligomenorrhea?
Oligomenorrhea is infrequent menstrual flow or very light menstruation. Women with oligomenorrhea often have around 4-9 periods per year, usually occurring with intervals of more than 35 days. When there is an absence of menstrual flow for more than six months, oligomenorrhea may become amenorrhea, which is the absence of menses. Oligomenorrhea is also commonly referred to as having irregular periods.
The most common symptom of oligomenorrhea is having irregular menstrual periods with an interval of more than 35 days without birth control medication. In some cases, women who skip one menstrual cycle may experience a heavier period on the next cycle. However, this can be quite normal and does not always signify a miscarriage.
Consult your gynecologist if you experience sudden changes in your menstrual cycle.
There are various causes of oligomenorrhea. They include:
- Polycystic Ovary Syndrome (PCOS) - PCOS is a type of hormonal disorder commonly experienced by women of reproductive age (15 to 49 years old). The most common symptoms of PCOS include infrequent menses, prolonged menstrual flow, or excessive levels of the male hormone called androgen. Small collections of fluid called follicles may also develop in the ovaries, making women unable to regularly release eggs. Even though the exact cause of PCOS is still unknown, the risk of developing long-term complications, such as heart disease and type 2 diabetes can be reduced through early diagnosis and treatment, including weight loss.
- Puberty - Oligomenorrhea is also a common occurrence in early adolescence and does not often necessarily indicate health problems. During the first years after menarche and right before menopause, a light menstrual flow can also be expected.
- Female Athlete Triad - Some females who vigorously exercise or play sports tend to have an increased risk of a syndrome called the female athlete triad, which is a combination of three components. These components include low energy availability or eating disorders, oligomenorrhea or amenorrhea, and low bone mineral density (osteopenia and osteoporosis). Female athletes can have all these conditions in the triad, while some can have one or two.
- Hypothyroidism - Severe hypothyroidism is often associated with ovulation problems. Hypothyroid female patients tend to usually have menstrual abnormalities, such as oligomenorrhea.
- Stress - Physical, mental, and emotional factors that can cause stress can also cause a woman to miss menstrual cycles.
- Hyperprolactinemia - Elevated serum concentrations of prolactin can also cause oligomenorrhea. High levels of prolactin may also indicate the presence of pituitary tumors.
- Perimenopause - Perimenopausal women are likely to experience oligomenorrhea due to fluctuating levels of hormones in their body.
- Chronic Illnesses - Chronic illnesses of nonendocrine glands, such as heart disease, lung disease, kidney problems, and chronic liver disease can also affect female menstrual cycles and cause oligomenorrhea.
Other causes of oligomenorrhea are:
- Psychological or emotional disorders (anorexia nervosa)
- Gonadotropin deficiency
- Decreased secretion of gonadotropin-releasing hormone (GnRH)
- Decreased pituitary function
- Too much exercise
- Autoimmune premature ovarian failure (POF)
- Oophorectomy (the surgical removal of the ovaries)
- Radiation exposure of the ovaries with X-rays
- Certain psychoactive drugs
- Anticancer medications
- The use of androgens and glucocorticoids
To diagnose oligomenorrhea, your healthcare provider will initially review your menstrual history. After history taking, a physical examination may be performed along with certain blood tests and imaging tests.
Having a light menstrual flow or missing a cycle does not always indicate a problem. However, in some cases, oligomenorrhea can be a sign of polycystic ovary syndrome (PCOS). Those who are sexually active may also be asked to take a pregnancy test.
How can birth control pills treat oligomenorrhea?
To help correct oligomenorrhea, some women may use birth control pills. Even though these pills can also cause oligomenorrhea, they can also help treat the condition. In some women, PCOS causes oligomenorrhea. In this condition, the female hormones estrogen and progesterone are imbalanced. In such cases, healthcare providers may prescribe a low-dose combination of birth control pills.
Synthetic forms of hormones are usually present in these pills. They regulate the menstrual cycle and bring it back to normal. Most combination pills are available in a pack of 21 or 28 pills. At the end of the course, menstrual bleeding is experienced by women. However, the results may still vary depending on the brand of the pill taken.
Taking birth control pills are a common treatment method used to help regulate menstrual cycles. They are also the first treatment prescribed when it comes to treating PCOS.
Since these pills contain synthetic hormones, they can suppress the pituitary-ovarian axis. When these pills are taken every week, there would be an abrupt drop in the levels of hormones each month, triggering the shedding of the uterine lining and causing the start of a menstrual cycle.
It is also very important to bear in mind that taking birth control pills can also have side effects and cause the following conditions:
- Weight gain
- Hair growth on facial areas
- Hair loss
- Hypertension or high blood pressure
- Autoimmune disease
- Thyroid disorders
- Blood clots
- Digestive problems
These pills can also further bring about an imbalance in the level of hormones since they are chemical drugs. Fortunately, natural therapies are also available. Such therapies include dietary changes, massage techniques, use of herbs, use of supplements, and techniques to reduce stress. These therapies not only help regulate menstrual cycles but also support your overall well-being.
Oligomenorrhea is not always a symptom of a serious medical condition. However, in some cases, it may also be a symptom of an underlying problem. It is also quite important to make sure that the cause of oligomenorrhea is not pregnancy.
There are still ongoing research studies regarding menstrual disorders. Researchers have been studying the role of hormonal regulation, low body fat, and genetics in menstruation.
The risk of endometrial cancer and endometrial hyperplasia also increases when women have less than four menstrual cycles every year for many years without taking medications, such as birth control pills.
It's time to see your doctor if you frequently have irregular menstrual cycles for more than 35 days.