So your period isn’t here yet and you’ve run a pregnancy test and you are not pregnant either. What could be going on? You may have an irregular cycle. Irregular periods/cycles happen from different causes ranging from hormonal imbalances to medical conditions, some more serious than others.
How do you know you have irregular menstrual cycles?
- You have less than 9 periods in a whole year
- You miss three periods in a row
- Your menstrual cycle length is less than 21 days or more than 35 days
- You have periods that last for more than 8 days.
- Your menstrual cycle length, the time from one period to the other varies a lot, usually with at least more than 7-9 days. For example, 28 days this month, 36 days next month and then 26 the month after its 34
And for girls who are just starting out, that will be:
- Not having periods by the age of 15
- More than 3 years after her periods starts, she has cycle lengths longer than 90 days, less than 21 days and more than 45 days.
All of these can be seen as irregular menstrual cycles. It’s Stephanie Nyong, the health teacher here again and I’ll be explaining 13 possible causes, how they happen, what you can do and when to visit the clinic.
So are there instances where irregular cycles can be normal? Yes! And these are during major transitions in a woman’s life;
- Puberty: a few years after a girl starts her period. She may have periods one month and nothing happens in the next one month or two and then shortly after that, it's back again. It can stay this way until about 2-3 years until it becomes regular.
- Menopausal transition: The time between a woman’s reproductive years and menopause. Women experience this differently. Most women experience it in their 50’s while some others may experience it in their 40’s or even mid-30’s. In this case it is referred to as early perimenopause
How and why does this happen?
At this stage, a woman has fluctuating levels of the estrogen hormone. You remember the estrogen hormone right? I talk about it a lot. It is the most famous female sex hormone and plays a very important role in the menstrual cycle.
In the first phase of your menstrual cycle, just before ovulation, estrogen is high. Basically, ovulation happens as quickly as your body reaches it’s estrogen threshold, that is it’s peak. At that point, the brain is signaled to produce the lutenising hormone which then triggers ovulation.
And ovulation is necessary for the next period if a pregnancy does not occur. So, if estrogen levels are dropping because a woman is at this stage in her life, it then affects the whole process and as a result, there may be significant changes in the length of her menstrual cycle, because it may take her body longer to reach the threshold or it may not even reach the threshold at all and as such ovulation will not occur.
Simply put, no ovulation(release of an egg)=No period
a lady may also have anovulatory cycles, cycles in which ovulation does not occur and all these may come alongside menopausal symptoms.
So once a lady experiences these and doesn’t see her periods for 12 consecutive months, one can then say, she is in menopause.
- Pregnancy: Through your menstrual cycle, the endometrium changes in structure. It builds up to be strong enough for the embryo and placenta to attach if a pregnancy does occur. Your period comes when your endometrial lining sheds because fertilisation did not occur. When you are pregnant, your period stops automatically and that's because you need the endometrium.
- Lactation: With breastfeeding comes lactational amenorrhea in some women. The first six months, there's no period at all. However, some women who do see their period while breastfeeding may notice irregularities like spotting, longer, shorter periods, or missed periods in some months. Like I always say, women are unique. In some others, they most likely wouldn’t see their periods at all for many months, maybe even years. Yours will definitely depend on how often you nurse your baby and of course your body’s interactions with hormones.
- Stress: I know you’ve heard it many times. You complain of irregular cycles and someone asks you are you stressed? Or you are trying to have a baby and they say “You have to reduce your stress levels. And you go like “Stress ke” wondering how this happens or if you are actually stressed enough to the point where your periods become irregular. You just don’t get it. I’ll explain how it happens.
The hypothalamus, a very small portion of your brain controls many activities happening in your body. Activities include regulating your heart rate, blood pressure and even your temperature amongst others. It also produces hormones that either start or stop the production of other hormones in your body.
I’m really not going to make this complicated at all. I’ll just tell you how it affects your menstrual cycle, straight to the point and thats it lol
The hypothalamus produces a hormone called Gonadotropin-releasing hormone. I hope I pronounced it right, lol. It is this hormone that causes the pituitary gland to produce LH, FSH that stimulates the maturity and release of the eggs from the ovaries. Now these hormones stimulate the release of estrogen and progesterone
The same hypothalamus also produces another hormone called Corticotropin releasing hormone which leads to the production of the stress hormone cortisol. Increased levels of this hormone can suppress the production of the reproductive hormones
So when you are stressed your body will prioritize the production of the stress hormones over the reproductive hormones. As far as it is concerned, you are in danger and it is helping you. When this happens, ovulation can be delayed or not even happen at all and no ovulation equals no period. You get that right?
Stress can be exercising too much, work stress, that job that’s almost driving you crazy lol. I’ve experienced it firsthand at some point in my life and I know what work stress feels like lol. Even eating too little, your body recognises it as stress.
You have to manage your stress levels in order to have a regular menstrual cycle. Some people listen to music, play games, and watch movies or even do Yoga. There’s been a lot of studies with results confirming that Yoga actually reduces stress levels. You might want to try that. So I'm curious. How do you manage stress? Tell us in the comments, you may be helping someone
- Hormonal Birth Control: So, basically hormonal birth control will work either of three ways; 1. Prevention ovulation from happening. You know If there’s no ovulation, there will be no egg for fertilisation hence, no pregnancy. 2. Prevent the sperm from meeting the egg and this would usually happen by thickening the cervical mucus at the neck of the womb, making it less conducive for sperm to travel from the vagina to the uterus and lastly, 3. It can thin the uterine lining preventing a fertilised egg from being implanted.
Hormonal birth control comes in different forms, it could be a pill, implant, injection, vaginal ring or an IUD. Depending on which you use, it can cause irregularities with your cycle for the first few months.
The pill usually comes in a combination of estrogen and progestin or progestin only. The combination pill will prevent ovulation and progestin only, which thins the endometrial lining and thickens the cervical mucus
So if the lining is thin, there’ll be nothing to shed as period
When it comes to the pills. There are some with 21/24 active pills and 7/4 inactive pills, basically just placebo’s. These active pills keep your body in a constant state of thinking ovulation has occurred. In the second phase of your menstrual cycle after ovulation. You get that right!
The active pills are taken first and the inactive pills taken afterwards which then reduces the levels of the hormones in the body and in turn will cause a breakthrough bleeding. Some women go on active pills for much longer, for those, there will be no periods at all until it is discontinued.
I hope I haven’t gotten you confused. Just go back and replay, you’ll get it. I promise!
With options like the implant or injection, your periods can even stop completely after a while.
So, with this form of birth control comes irregular periods...but whatever option you choose, these irregularities will usually clear up within 3 months. If it doesn’t or you experience unbearable side effects even after this time, please contact your healthcare provider. You can always change to a better option with less side effects. Let me know in the comments, videos you’ll like to see when it comes to birth control. What do you want to learn because I’m putting something together already.
- Extreme or intense exercise
Exercise isn’t bad. As a matter of fact, it is very essential for healthy living. Exercise burns calories right! Perfect but you need an energy balance to keep your body’s processes working. When you burn too much, your body will not have enough energy to run these processes and one of them is ovulation. Your body will prioritise some processes over others just like I explained earlier with stress. It will see the production of reproductive hormones as non-essential. I mean there are more important stuff to deal with Lol
And so it’s no surprise that research has shown over 60% of female athletes have to deal with irregular periods- either missed or late periods. Some have even stopped seeing the period totally.
So check it, you may have just moved from doing 10-20 minutes of exercise or doing none at all to doing 60 mins a day because you are desperate to get that body. That may just be what’s affecting your periods. So, the key is balance. Find a balance. Exercise moderately and eat well too.
8.PCOS- Polycystic ovary syndrome. This is a hormonal disorder common amongst women of reproductive age and irregular periods is a symptom. Women with this condition may also have elevated levels of the male hormone testosterone, resulting in physical signs, such as acne, excess hair on the face and body.
These women may see that their cycle lasts longer than 35 days. For some women, it may be up to 40, 50 days or even more between periods and I’ll explain how this happens.
Your ovaries contain all the eggs you will need in your lifetime. As a matter of fact, when a girl is born, she has about 1-2 million eggs. These immature eggs are stored in fluid filled sacs called follicles where they grow to maturity. At the beginning of the menstrual cycle, a woman may have as many as 1000 eggs begin to mature but only one egg will reach it’s fully mature state for ovulation, the remaining will die.
Remember the Follicle Stimulating Hormone causes the eggs to mature and the Lutenizing hormone causes the release of the egg from the follicle in ovulation. When a woman has PCOS, there’s usually low levels of the follicle stimulating hormone, high levels of the Luteinising, estrogen and testosterone hormone going into the bloodstream, disrupting the normal process and what you see happen is; the follicles will not be able to mature, ovulation will not occur and instead of the remaining follicles to dissolve they turn into fluid filled sacs, like cysts. So when you do an ultrasound, you see your ovaries looking something like this with dark holes.
These are multiple cysts in the ovaries.
Most women with this condition tend to suffer from what they call “anovulatory infertility-” infertility happening as a result of the fact that ovulation does not occur. When the period finally comes, it can be really heavy. You’ll notice I said most women because some others will ovulate from time to time.
- Thyroid Problems- The thyroid gland is located just below your Adam's apple. This gland controls several activities in the body including your menstrual cycle. It produces the thyroid hormone. Too much or too little of this hormone can cause menstrual cycle irregularities.- irregular periods, no periods at all, too light or too heavy periods
- Hyperprolactinemia: Simply put, this means too much prolactin in the blood of women who are not pregnant. It’s a condition that can result from the previous point I mentioned. When there is low production of Thyroid hormones, it will lead to increase in production of prolactin. Prolactin is a hormone that causes the breast to grow, develop and also stimulates the production of breast milk. Too much prolactin in the blood can suppress ovulation. In some women who have this condition, they experience nipple discharge.
As a matter of fact when women report to the clinic and complain of nipple discharge, one question they get asked first is if they have regular periods. It’s usually as a result of the hormonal imbalance.
I guess now you know the reason why breastfeeding mothers do not have their monthly cycles. In my next video, I’ll be talking about how Nipple Discharge can affect a woman’s fertility and what to do about it. Make sure you subscribe to get updates if you aren’t already.
- Medications- Medications like antipsychotics, anti-epileptics, antidepressants, blood pressure drugs and even cancer therapy drugs can cause irregular menstrual cycles
- Overweight- Being overweight can affect hormone levels which will in turn affect your menstrual cycle. Also, gaining a lot of weight in a short period, can have the same effect. So you want to stay active and eat a healthy diet.
- Sleep- There's something called circadian rhythms. It's a range of physiological and behavioural changes that follow a 24 hour clock. It is believed that nearly every human cell in the body has a biological clock. These rhythms influence very important bodily functions, sleep, your temperature, mood and even the release of hormones amongst others.
The most common is the sleep-wake cycle which is directly connected with day and night. You wonder why when it’s late, your body automatically wants to go to sleep mode and hours later when it’s bright, you wake up. A normal sleep-wake cycle will ensure that you sleep very well and have enough energy during the day to go about your normal day to day activities.
When you are not sleeping well, your body sees it as stress. You remember I discussed earlier how stress affects your menstrual cycle-Your body will prioritise the production of cortisol, the stress hormone over your reproductive hormones that ensure a normal menstrual cycle and when that happens you begin to notice an irregular menstrual cycle.
The circadian rhythm is a real thing and its disruption have been studied in women of reproductive age severally especially in shift workers, who mostly work at night and results have shown menstruation disorders. You need to sleep well.
Irregularities need to be caught early and treated/managed to prevent complications. Complications can range from diabetes to endometrial cancer, cervical cancer or the most common, infertility. So don’t sit in your house and say errrm. My cycle isn’t always regular, after a few months, it will come back to normal. That’s not good enough.
You also have to know what is normal for you first, to be able to catch an irregularity early enough. I mean if you do not know your average menstrual cycle length for example, how then will you know if your cycle is within the normal range? And you have to do that by mastering your menstrual cycle. I can’t count how many times I’ve asked ladies about their menstrual cycle length when they complain of irregularities and I hear things like 4 days, 5 days- Your menstrual cycle length is different from the duration of your flow and these are basic things you should know- It’s called body literacy. It will save you a lot of stress.
Once you think you experience irregularities, visit the clinic for proper diagnosis and treatment or management as the case may be. If you would like a consultation with a gynecologist, you can book one with us wherever you are and you’ll be sure to get the care you need.
There are several videos and articles where I have thought how to chart your menstrual cycle in the past using different methods. I’ll link them below, you can check them out. There’s also my basic course for beginners, Chart Your Menstrual Cycle. You can start your journey from there- if you are trying to conceive or just want to monitor your reproductive health. More details are just below this link. Don't forget to drop your questions if you have any. Cheers!
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