Irregular menstrual cycle - a slight inconvenience or a real threat?

Your menstrual cycle says a lot about your health. It is necessary not only to monitor it, but also to respond to violations.

Do you know when your last menstrual period started or how long it lasted? If not, it may be time to pay attention. Monitoring your menstrual cycle will help you know when you ovulate and what is normal for you, as well as notice important changes such as a missed period or sudden bleeding. Although menstrual irregularities are usually not serious, they can sometimes signal health problems.

What is the menstrual cycle?

The content of the article

The menstrual cycle is a series of changes each month that a woman's body undergoes under the influence of hormones. Every month one of the ovaries releases an egg. The process of its release is called ovulation. At the same time, hormonal changes prepare the uterus for the expected pregnancy. If ovulation occurs, but the egg remains unfertilized, the inner mucous layer of the uterus - the endometrium - is torn off and comes out through the vagina. This is what we call menstrual bleeding.

Unnatural causes of irregular periods

Many diseases, medications, and even life situations can cause a disruption in the cycle. Common reasons are 3:

• Disturbances in the production of certain hormones. The most noticeable pathology is hyperprolactinemia, in which the hormone prolactin is produced. This hormone provokes breast growth, milk production and inhibition of the menstrual cycle.
• Various diseases of the ovaries (polyxtosis).
• Neoplasms in the female reproductive system - cystomas and fibroids.
• Inflammatory processes and genital infections.
• Endometriosis is a hormonal imbalance that disrupts the cyclicity of menstruation.
• Taking medications, predominantly of the hormonal type.

An interesting experiment was conducted within the walls of the Institute of Cytology and Genetics. Researchers have tried to establish a relationship between female scent and attractiveness. Completely anonymous, men gave positive or negative points for smell. Thus, based on statistics, an attractive type of female scent was determined. The experiment found that girls with irregular menstrual cycles received significantly lower grades than girls with regular cycles. This can be associated with the fact that the male brain reflexively gives the body a command to interrupt contact with a woman who may have problems with reproductive functions4.

What menstrual period is considered normal?

The duration of the menstrual cycle is counted from the first day of menstruation until the first day of the next bleeding, and is not the same for all women. It can vary from 21 to 35 days. The duration of bleeding ranges from 2 to 7 days.

In the first few years after the start of menstruation, long cycles are common. However, menstrual periods tend to become shorter and more regular as you approach menopause. Your cycle may be regular - approximately the same length every month, or unstable; your monthly bleeding can be light or heavy, painful or not problematic, long or short, and still be considered normal. In a broad range, “normal” is whatever is normal for you.

Keep in mind that using certain types of contraception, such as the pill and intrauterine devices, will change your menstrual cycle. Talk to your gynecologist about what to expect.

As you approach menopause, your cycle may become irregular again. Because your risk of developing uterine cancer increases with age, talk to your doctor about any bleeding you experience between periods or after menopause.

Lecture “How to avoid becoming a victim of a gynecologist”

Introduction

It just so happens that the reproductive function is activated in the girl’s body at the moment when she does not care about this function at all.
Having just put the dolls aside, the girl is faced with a whole series of little-understood processes occurring in her body, which immediately begin to be heatedly discussed among her peers, with consultations from those who are older. And mothers in this situation do not always rise to the occasion, since they themselves are poorly versed in this topic. So, let’s figure out once and for all what happens to you every month, dear women, what is considered normal, what should alert you.

Most women, when asked about the duration of their menstrual cycle, answer with a similar phrase “about once a month, a couple of days earlier than in the previous month”

- this intricate phrase denotes the duration of the cycle of 28 days. This cycle length occurs in most healthy women, but does this mean that a shorter or longer cycle is a manifestation of pathology? No!

It is recognized that a normal menstrual cycle can last from 21 to 35 days

, that is, plus or minus a week from the average of 28 days. The duration of menstruation itself can normally range from 2 to 6 days, and the volume of blood lost should be no more than 80 ml. A longer cycle occurs among residents of the northern regions, a shorter cycle among those living in the southern regions, but this is not an absolute pattern.

Regularity is important in the menstrual cycle.

That is, if a woman’s cycle is always 35-36 days, then this can be absolutely normal for her, but if it is either 26, then 35, then 21, this is not the norm.
Thus, a pathology can be considered irregularity
(when menstruation comes at an unequal period of time),
a long cycle
(more than 36 days) or
a short cycle
(less than 21 days). In general, the menstrual cycle can vary greatly depending on the condition of the woman and the situation in which she finds herself.

However, the lability of the menstrual cycle varies among different women depending on external and internal factors. For some, a little stress can already lead to a delay in menstruation, while for others, severe depression is not a reason for menstrual irregularities. The menstrual cycle of one woman can adapt to the menstrual cycle of another if they live together for a long time. This is often seen on women's sports teams or when living together in a dorm. It is not entirely clear what explains this fact. All we can say is that the menstrual cycle

Although it is a clear mechanism,
it can change significantly in a normal healthy woman
, and these changes are a reflection of the body’s reaction to external and internal factors.

The menstrual cycle is not always stable

The most irregular period is the first two years after the start of menstruation and three years before its end (menopause). Violations during these periods are due to completely physiological reasons, which we will discuss below.

Where do these numbers come from and why might they change?

The menstrual cycle is divided into three phases:

menstruation, the first phase (follicular) and the second phase (luteal). Menstruation lasts on average 4 days. During this phase, the lining of the uterus (endometrium) is shed due to failure to become pregnant.

First phase

lasts from the end of menstruation until ovulation, that is, on average until the 14th day of the cycle with a 28-day cycle (the days of the cycle are counted from the moment the menstruation begins).

This phase is characterized by the following events:

several follicles begin to grow in the ovaries (from birth, the ovaries contain a lot of small vesicles (follicles) containing eggs). During their growth, these follicles secrete estrogens (female sexual hormones) into the blood, under the influence of which the mucous membrane (endometrium) grows in the uterus.

Shortly before the 14th day of the cycle, all follicles except one stop growing and regress, and one grows to an average of 20 mm and bursts under the influence of special stimuli. This process is called ovulation. An egg emerges from the ruptured follicle and enters the fallopian tube, where it awaits the sperm. The edges of the ruptured follicle gather (like a flower closing for the night) and this formation is now called the “corpus luteum.”

Immediately after ovulation, the second phase of the cycle begins.

It lasts from the moment of ovulation until the start of menstruation, that is, about 12-14 days. During this phase, the woman's body waits for the pregnancy to begin. In the ovary, the “corpus luteum” begins to flourish - the corpus luteum formed from the burst follicle sprouts vessels and begins to secrete another female sexual hormone (progesterone) into the blood, which prepares the uterine mucosa for the attachment of a fertilized egg and the beginning of pregnancy. If pregnancy does not occur, then a signal is sent to the corpus luteum and it curtails its work.

When the corpus luteum stops secreting progesterone, a signal is sent to the uterus, and it begins to reject the no longer needed endometrium. Menstruation begins.

With different cycle lengths, the duration of the phases is reduced - this means that one woman needs 10 days for the follicle to mature, while another needs 15-16.

Having understood what the menstrual cycle consists of, it is easy to understand what determines its duration normally and in the presence of pathology.

Why is everything often unstable at the very beginning and then, after childbirth, it gets better?

A woman's reproductive system matures gradually and, being a complex mechanism, requires a period of adjustment.

The fact that a girl has her first menstruation
does not mean that her system is mature and ready to work fully
(although for some, the menstrual cycle begins to work correctly from the very beginning).

The functioning of the female reproductive system can best be compared to an orchestra, the coordinated play of all the instruments of which creates the unique sound of a piece of music - in our case, the regular menstrual cycle.

Just as instruments in an orchestra require a period of tuning, all components of the reproductive system need to agree with each other to understand and work together harmoniously. Such a rehearsal usually takes about 6 months - for some it is longer, for others it is shorter, and for others it may take longer.

Why do there be delays or do my periods start earlier?

Everything is very simple - if during the first phase of the cycle it is not possible to grow a full-fledged follicle, which could burst in the middle of the cycle (ovulation), then the second phase of the cycle, accordingly, does not begin (no ovulation - there is nothing to form the corpus luteum from). The first phase lasts a long time, until the uterine mucosa (endometrium), which has grown under the influence of estrogen, begins to be rejected on its own (like a pyramid of cubes collapses when it is stood too high). The cycle in this situation can last up to several months.

In this case, in the next cycle, ovulation may occur and the cycle will have a normal length. When such alternation occurs, they speak of an irregular menstrual cycle.

Another reason for delayed menstruation may be the existence of the corpus luteum for too long.

As I noted above, it lives for about 10 days and then begins to curtail its work, since pregnancy has not occurred. But sometimes it happens that despite the fact that pregnancy has not occurred, the corpus luteum continues its work and menstruation does not occur, and occurs only when the corpus luteum finally decides to leave.

Earlier onset of menstruation

This is usually due to the fact that the notorious corpus luteum, on the contrary, stops its work too early. This leads to an earlier onset of menstruation.

Remember how the orchestra sounds when it tunes its instruments - the same cacophony from the menstrual cycle is often observed at the beginning. The components of the reproductive system negotiate so that they can grow a follicle in 14 days, start the ovulation process, and maintain the corpus luteum for at least 10 days. At the beginning, she does not succeed in all stages of this work and this is manifested by an irregular menstrual cycle.

But this adjustment can be seriously interfered with by the person himself. Nothing has such a negative effect on the development of the reproductive system as stress.

(intense study, exams, unhappy love),
intense sports training, extreme weight loss, frequent illnesses, smoking, alcohol and drugs.
Against the backdrop of all of the above, quite often
menstruation disappears
and then you have to wait a long time for them. And the reason is very simple, I would say there is simple biological expediency in this - in extreme living conditions and when, for health reasons, a woman cannot bear healthy offspring - the reproductive function is switched off until better times. It’s not for nothing that during the war, most women stopped menstruating; this phenomenon was even given a special term “wartime amenorrhea.”

What to do about it?

Let me make a reservation right away that I am not taking into account various diseases, I am talking about some common problems with adjusting the menstrual cycle. Such cycle disorders are solved by taking hormonal contraception. Here we need to return again to the comparison with the orchestra. If the orchestra starts to go out of tune, you must stop playing completely, give the musicians a rest and start again. Hormonal contraception does just that. She turns off the reproductive system and “rests” the entire time she takes contraception. Then, after its cancellation, the system begins to work again and, as a rule, the cycle failures disappear.

Why does the cycle quite often become stable after childbirth, and sexuality flourishes?

The orchestra can rehearse as much as it wants, but it is finally played only when it performs its first concert from beginning to end. Pregnancy is the only purpose for which the reproductive system is designed in the body.

Only after the first full pregnancy, which ends in childbirth and the period of breastfeeding, the reproductive system matures completely, since during this period all the functions provided by nature are realized. After pregnancy, a woman finally matures and all the not fully “unpacked” properties of the body finally begin to work in full force.

The reproductive system must be used for its intended purpose - this is important; menstruation is not a function of the reproductive system, but a monthly reminder that it exists at all and is still working.

Let's step beyond 30...

Time passes, the reproductive system, which on average is allotted to exist in working order for 38 years (from 13 to 51), instead of performing its function is limited only to regular menstruation.

For reference:

on average, a woman experiences about 400 menstruation during her life (with 2 births) and loses about 32 liters of blood, while during reproductive behavior (pregnancy, childbirth, 3 years of breastfeeding, and only then 1-2 menstruation and pregnancy again ) there are about 40 menstruation periods.

In addition, as a woman ages, her history of various gynecological and general diseases

, and all this begins to affect the state of the reproductive system and, therefore, is reflected in menstrual irregularities.
Inflammation, abortion, gynecological operations, overweight or underweight, and common chronic diseases can cause problems.
Menstrual irregularities in the form of delays or earlier onset of menstruation a couple of times a year can occur even in the absence of any pathology.

As a rule, this is due to climate change or other stresses on the body (illness, hard work, personal problems, etc.). All nervous professions can lead to either delays in menstruation, their earlier onset or complete cessation.

Every woman is different, so everyone's cycle will change differently depending on the type of stress response and the phase of the cycle in which it occurs. For the majority of women, nerve work does not affect their menstrual cycle at all. Cycle disorders

, especially if it was stable before, often make a woman think that something is wrong with her.
Not in all cases you need to panic.
If you can clearly remember any negative events in the recent past that greatly shocked you, then most likely this is a one-time cycle disruption and there is nothing wrong with it. If there is no menstruation for a very long time (and the pregnancy test is negative), then you need to consult a doctor. If menstruation came earlier and does not end, this is also a reason to rush to see a gynecologist.

Sometimes cycle disorders can manifest as very frequent menstruation

(several times a month).
And there is no need to delay it - see a doctor immediately. But if the regularity of the cycle disappears completely
, this is also a reason to consult a doctor.

Regularity

– the main indicator of the normal functioning of the reproductive system. Sometimes it happens that a cycle had one duration and suddenly becomes shorter while maintaining its regularity. As a rule, this is due to the fact that the second phase of the cycle becomes shorter, as the corpus luteum begins to work less. Such changes are more often observed closer to 40 years. This is not a reason to panic, but simply a reflection that your reproductive system will change as you age, just like you.

Early menopause

This is one of the very common fears of women. In fact, this fear is exaggerated, since early menopause is quite rare

. It is mainly caused by rare congenital diseases, rare systemic diseases, consequences of treatment (chemotherapy, radiation therapy for cancer) and other rare conditions. There are situations when, as a result of surgery, a woman’s ovary or part of it is removed. Then menopause may occur earlier due to the fact that there is little tissue left in the ovaries that could support the normal functioning of the reproductive system.

Early menopause

As a rule, it is manifested by the cessation of menstruation and the appearance of symptoms of insufficiency of female sex hormones (hot flashes, irritability, tearfulness, insomnia, etc.). There is no prevention of this disease.

Painful periods and PMS

For some reason, it is generally accepted that feeling unwell during menstruation is normal.

The presence of pain, nausea, and migraines during menstruation
is not normal.
This condition of painful menstruation is called
dysmenorrhea
and requires treatment. Even if these phenomena are expressed insignificantly, they can and should be corrected.

Dysmenorrhea

It can be either
primary
(most often at a young age), when it is most likely due to simply the immaturity of the reproductive system, and
secondary
– when it is a reflection of a number of serious
gynecological diseases
.

The same applies to premenstrual syndrome. In general, the widespread popularization of this syndrome allows women to attribute their sometimes not entirely adequate actions and behavior to manifestations of this syndrome. However, PMS is not a woman’s personality trait.

, which everyone has to put up with.
PMS is a disease
that has incompletely understood causes, a whole list of symptoms and specific treatment measures. Manifestations of PMS can and should be corrected. It is wrong to take monthly illness for granted in modern conditions. If you have such problems, consult a doctor.

How it all ends

Decline of the reproductive system

usually occurs in the same way as its formation. Menstruation becomes irregular and there is a tendency to be delayed. This is due to the same reasons as in the beginning.

The ovaries respond less well to stimuli from the brain. It is not possible to grow follicles that could reach ovulation - accordingly, the cycle is delayed. If ovulation occurs periodically, the resulting corpus luteum does not work well. Because of this, periods either start earlier or, on the contrary, are delayed for a long time. Eventually your periods will stop, and if you haven't had them for more than 6 months, you should see a doctor. Based on hormonal tests and ultrasound, the onset of menopause can be assumed.

Sometimes there are cases when menstruation stops for a long period of time

, and according to tests and ultrasound, the onset of menopause is expected. This can be especially frightening for young women. However, this may only be a temporary period, and menstruation may resume on its own, for example after proper rest.

Thus, the myth that 28 days is the norm and everything that differs from this figure is pathology has been debunked. The main thing in the menstrual cycle is its regularity, and the duration of the cycle can fluctuate over a wide range.

And yet, there is a simple rule: if you regularly undergo preventive examinations with a gynecologist (at least once a year), if any violations appear, do not put off an “unpleasant” trip to the gynecologist - then you will almost never have serious gynecological problems.

Video version:

How to track your menstrual cycle?

To find out what's normal for you, start dating your menstrual cycle on a calendar, writing down the start date of each cycle for several months in a row. This way you will determine the regularity of your periods. Pay attention to the following indicators:

• The end date is how long your period lasts;
• Amount of bleeding. Presence of blood clots. Frequency of changing sanitary pads or tampons;
• Abnormal bleeding, where you bleed between periods;
• Soreness. Note any pain associated with your cycle: whether it intensifies or not;
• Any other changes, including mood or behavior changes.

Causes of menstrual irregularities

Menstrual irregularities can have many different causes, including:

• Pregnancy or breastfeeding.
  A missed period can be an early sign of pregnancy. Breastfeeding usually delays the return of menstruation after pregnancy;
• Eating disorders, extreme weight loss, or excessive exercise
  interfere with menstruation;
• Polycystic ovary syndrome (PCOS).
  Women with this common endocrine system disorder may have irregular periods,
• Premature ovarian failure
  refers to the loss of normal ovarian function before age 40. Premature ovarian failure, known as primary ovarian failure, causes irregular or sporadic cycles over many years;
• Pelvic inflammatory disease
  often causes irregular menstrual bleeding;
• Uterine fibroids
  are benign growths in the uterus. They can cause heavy and prolonged bleeding.

Natural Causes of Irregular Periods

An irregular cycle does not always indicate health problems or any pathologies of the reproductive system. The reasons may be quite logical and natural, among them:

• postoperative period;
• aging of the body and menopause;
• puberty (puberty);
• abortion;
• pregnancy;
• postpartum recovery period.

Some reasons are worth examining in more detail. A teenage girl experiences her period between the ages of 11 and 14. It takes quite some time for the regularity of the cycle to develop. A teenager still has insufficient sex hormones and there is no need to talk about the stability of the menstrual cycle. Such a period can last up to two years, which is considered a natural cause of cycle irregularity2.

After childbirth, the female body behaves in a special way. The hormone prolactin (responsible for the formation of milk), in addition to its main function, is involved in the restructuring of hormonal levels, which leads to disruption of the menstrual cycle.

Having gone to the future, a woman’s body enters the menopause stage - aging and failure of the reproductive system occurs. The concentration of sex hormones drops, which naturally leads to an irregular menstrual cycle, up to its complete disappearance.

Some doctors attribute stress and nervous feelings to natural causes. It has been established that a woman’s psychological state can also affect the menstrual cycle.

With the exception of menopause, some severe types of abortion and surgical interventions, the menstrual cycle that is “wrong” due to natural causes is always restored.

How to prevent menstrual irregularities

For some women, using birth control pills helps regulate their menstrual cycle. Addressing any triggering issues, such as an eating disorder, also helps. However, some menstrual irregularities cannot be prevented.

Also, consult your doctor if:

• Your periods stopped suddenly for more than 90 days and you are not pregnant;
• Menstruation lasts more than seven days;
• Heavy bleeding with changing several pads or tampons every hour or two hours;
• Your periods last less than 21 days or more than 35 days;
• You bleed between periods;
• Severe pain during a period;
• You suddenly feel chills or pain after using tampons.

Remember that monitoring your menstrual cycle will help you know what is normal for you and what is not.

If you have questions or concerns about your menstrual cycle, visit a gynecologist at Diana Medical Clinic in St. Petersburg to identify the causes. Tel.