Ask any woman what she dreads the most each month, and she'll mention menstrual cramps, bloating and PMS. But, what about those women who also suffer from irregular menstrual bleeding? Not only do they need to deal with the same menstruation issues as the others, but they're also caught unaware and have to ensure that this irregularity isn't a manifestation of some physical imbalances. Today, Dr. Madhu Goel, Consultant, Gynecologist at Rockland Hospital, New Delhi tells us what we need to know about irregular menstrual bleeding. Read on...

Understanding irregular menstrual bleeding

A normal menstrual cycle is usually regular. The duration of bleeding can vary from 2-7 days and the interval between 2 cycles (time between first day of 1 period and the first day of next) can be 28+_ 7 days. The average blood loss is about 60-100ml. Any deviation from this is considered abnormal menstrual bleeding.

Pregnancy and irregular menstrual bleeding

The most common reason of irregular menstrual cycle in reproductive age group is usually related to pregnancy. If you miss your periods, a pregnancy test is a must. Sometimes a pregnancy also occurs in an unsuspecting perimenopausal patient (near menopause). Also, if   bleeding occurs after being overdue, it may indicate an abortion or something sinister like ectopic pregnancy (pregnancy outside the uterus). Hence, the first step is usually a pregnancy test.

Irregular cycles are also a common feature of the post-pregnancy period. While breast feeding, the periods may get delayed or be irregular. This is perfectly normal and not a cause of concern. But again, precautions against a fresh pregnancy is a must. 

Perimenopausal period and irregular menstrual bleeding

Irregular cycles also occur in the perimenopausal period. While some changes in the cycle are acceptable and do not require treatment, others like excessive bleeding, bleeding in between cycles require further evaluation. Bleeding after attaining menopause is not normal and must be investigated.

Contraception and irregular menstrual bleeding 

Certain forms of contraception can also result in irregular cycles. Post pill amenorrhoea is sometimes seen, that is even after stopping the pill there may be a period of no bleeding. Pills may also cause scanty bleeding or breakthrough bleeding (bleeding between cycles). IUCD (Cu T, Multiload) may also result in heavy or irregular bleeding. Injections given after childbirth for contraception may also cause irregular bleeding.

Weight issues and irregular menstrual bleeding 

Significant weight gain or weight loss may also cause irregular cycles. Significant weight gain may also indicate the presence of a thyroid disorder . Thyroid disorders are very common in women and cause weight gain, irregular cycles, lethargy etc. Weight gain may also signify the onset of Polycystic Ovarian Disease which is a hormonal problem and may require treatment. Weight loss may indicate an underlying systemic condition  like cancer, tuberculosis etc. Weight gain, or weight loss may also indicate various eating disorders like anorexia nervosa, bulimia nervosa.

Emotional stress and irregular menstrual bleeding 

Severe emotional stress is seen in cases of exams, loss of job, loss of someone dear etc. These can also cause irregular bleeding. 

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