What causes absent or irregular periods? Dr. Greves explains possible diagnosis and treatment options

Most women dread their monthly menstrual period, despite it being the sole component of the body’s ability to reproduce. What exactly is a menstrual period? Menstrual periods occur when a woman matures to the point of making enough hormones. Each month, the lining of the uterus prepares for a fertilized egg. If the woman does not become pregnant, the hormones in her body will drop, and the lining of the uterus will be sloughed off and leave the body as a menstrual period.

What’s the difference between absent periods, irregular periods and spotting? What are some common causes?

Absent periods are periods that do not happen at all, and irregular periods are periods that happen less than six to eight times a year. And sometimes, a woman will just “spot.”

The most common cause of missing a period is pregnancy. In some cases, she may have a medical condition that affects her hormone levels, and she will have either absent or irregular periods. “Spotting” can also occur during pregnancy, the presence of endometrial polyps, or can be caused by other medical conditions.

Other specific causes of absent or irregular periods and spotting are a result of the following conditions, which affect the normal hormone cycle:

1. PCOS (which stands for “polycystic ovary syndrome”). In women with this condition, the ovaries make too much male hormone. This can disrupt a woman’s periods and cause excess facial hair, acne, and problems with weight. PCOS is the most common cause of absent or irregular periods.
2. Some medicines, including birth control pills.
3. Being too thin or having too little body fat.
4. Exercising too much.

Another cause of absent or irregular periods is menopause. Menopause is the time in a woman’s life when she naturally stops having periods. Menopause usually occurs between the ages of 45 and 55.

If I am affected by absent periods, irregular periods, or spotting, what are my treatment options?

The current recommendations for seeing a health care provider include the following:

1. You are older than 15 and still have not had your period.
2. You used to get periods, but you have not had a period for more than three months.
3. Your periods happen more than 45 days apart.

When you make an appointment with your health care provider, he/she will want to know if you:

1. Think you might be pregnant
2. Have family members with irregular periods
3. Have bad acne or hair on your chest or face
4. Have gained weight and are having trouble losing it
5. Have hot flashes, which feel like a wave of heat that starts in your chest and face and then moves through your body
6. Have night sweats, which are hot flashes that happen when you are asleep
7. Have new headaches or trouble seeing
8. Notice milky fluid coming out of your breasts
9. Are under a lot of stress
10. Have recently lost weight
11. Are exercising more than you used to
12. Have changed how much you eat, or what kinds of foods you eat
13. Are taking any medicines, herbs, or vitamins

Some of the tests that might be recommended by your physician include the following:

1. Pregnancy test – Pregnancy is a common cause of missed periods. Your doctor will want to find out if you are pregnant before doing any other tests.
2. Blood test – This will measure hormones that affect the reproductive system.
3. MRI – This test uses a large magnet to make detailed pictures of the brain. It can show if there is a problem in the part of the brain that controls the body’s hormones.
4. Pelvic ultrasound – This test uses sound waves to make a picture of your uterus, cervix, and vagina. The picture can show if there is something wrong with any these organs. This test may be done through the birth canal.
5. Pap smear

The treatment of an absent or irregular period depends on the cause of the condition, but treatments may include the following:

1. Birth control pills to make periods regular.
2. Weight loss (if you are overweight).
3. Medications to help you get pregnant if you are having trouble getting pregnant on your own.
4. Changing the way you eat and exercise, such as: eating more calories to help you gain weight if you are too thin, or easing up on exercise if you exercise a lot.
5. Reducing stress.
6. Hormones to treat hot flashes (if you are going through early menopause).
7. Surgery to fix problems in the reproductive system.

To prevent the return of an absent or irregular period, your health care provider may recommend eating well and staying at a healthy weight. Being too thin or overweight can cause irregular periods, but can easily be prevented with some simple lifestyle changes!