Irregular cycle

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Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

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An irregular cycle is common - very few women get their menstrual bleeds at absolutely regular intervals. The cycle duration usually fluctuates slightly. Influencing factors are, for example, stress and a change of location or climate. However, diseases can also be the trigger for irregular bleeding. Read the essentials about the causes and treatment options for an irregular menstrual cycle.

Irregular cycle: description

If menstrual bleeding does not occur at regular intervals, the cycle is irregular. The menstrual cycle usually lasts 26 to 32 days, with bleeding lasting two to seven days. Deviations from this "normal", regular menstrual bleeding are called menstrual disorders (menstrual disorders).

Common menstrual cycle disorders are:

A prolonged cycle duration (oligomenorrhea) or an infrequent menstrual period is present if the overall cycle extends to 35-90 days.

With a shortened cycle duration (polymenorrhea), the bleeding is less than 25 days apart.

If the menstrual period is weakened (hypomenorrhea), the cycle is usually also shortened and there is less blood loss of less than 25 ml.

Doctors speak of increased menstrual bleeding (hypermenorrhea) if more than 80 ml of blood is lost during a cycle.

If the menstrual period lasts too long (menorrhagia), the bleeding continues for 8 days to two weeks. This often leads to increased blood loss (hypermenorrhea).

Additional bleeding or intermenstrual bleeding (metrorrhagia, menometrorrhagia also called “spotting”) describes bleeding that occurs outside of the cycle and therefore unexpectedly.

Amenorrhea (amenorrhea) describes the complete absence of the menstrual period. It can be congenital (primary) or can only occur after a cycle has already existed (secondary).

You can read more about prolonged and increased menstrual bleeding in our article on hypermenorrhea and menorrhagia.

Symptom: causes and possible diseases

An irregular cycle can have a variety of causes, such as:

Puberty and menopause: Due to the hormonal imbalance during puberty and menopause, an irregular cycle is very common in these phases of life.
Chronic fallopian tube and ovarian inflammation (adnexitis): A possible sign of chronic adnexitis is an irregular cycle with alternating abdominal pain throughout the cycle. Constipation and gas can also occur. Chronic adnexitis occurs when acute adnexitis is not treated successfully or because of scarring changes after the inflammation has healed.
Miscarriages: Repeated miscarriages can manifest themselves as irregular, infrequent menstrual periods with labor-like pain.
Benign ovarian cysts (polycystic ovary syndrome): An irregular cycle with rare menstrual bleeding (oligomenorrhea) as well as increased ("male") hair (hirsutism) and excessive weight indicates polycystic ovarian syndrome (polycystic ovary syndrome) - a malfunction of the ovaries Cause is unclear.
Malignant ovarian tumors (ovarian carcinoma): This often aggressive form of ovarian cancer usually only occurs after the menopause.

Hormonal disorders caused by diseases:

Dysfunction of the thyroid gland (over and underactive thyroid) also lead to impaired hormone production in the ovaries, which can change the cycle.
High or low blood sugar (diabetes) also counteracts egg maturation and can cause irregular bleeding.
Severe underweight and anorexia nervosa trigger a restricted metabolism. This also limits the hormone production necessary for ovulation. As a result, there is often no bleeding at first, and fertility is negatively affected, in pronounced cases infertility is the result.
Underactive anterior pituitary gland (HVL insufficiency) prevents normal hormone production by the pituitary gland. That affects the cycle. We cause HVL through head injuries or tumors.

Other influencing factors on the hormonal system:

In addition to illnesses, external influences such as stress and psychological stress also disrupt the hormonal balance.
Unhealthy diet, addictive substances (alcohol, nicotine, or other drugs) but also competitive sport, climate changes and time differences cause irregular bleeding
Even starting or stopping hormonal contraceptives (pill, hormone coil or other forms) bring the hormonal balance significantly out of balance and can trigger a disturbed cycle.

The hormonal system controls the normal cycle, which is why, conversely, hormone fluctuations in women often lead to a disturbed, irregular cycle.

Everything about spotting and intermenstrual bleeding (metrorrhagia) can be found in our article on spotting.

Irregular cycle: when should you see a doctor?

See a doctor if:

an irregular cycle occurs after previously regular menstruation.
the irregular cycle is associated with rare bleeding and labor-like pain.
the irregular cycle is accompanied by alternating abdominal pain throughout the cycle.
the irregular cycle is associated with rare bleeding and male hairiness (such as chest hair, beard growth) and weight gain occur.
the irregular cycle is accompanied by rapid weight gain or loss.
you suddenly stop menstruating for no apparent reason.
Spotting occur.
Menstrual cycle bleeding after stopping hormonal contraceptives has been absent for more than six months.

Irregular cycle: what does the doctor do?

The doctor will first talk to you in detail about your medical history (anamnesis). For example, he asks for a precise description of the irregular cycle, any general illnesses (e.g. metabolic diseases), mental disorders, strong weight fluctuations and the use of medication.

Various examinations can then follow to uncover the exact cause of an irregular cycle or other cycle disorders:

Physical and pelvic exams: These are routine when investigating irregular menstrual cycles and other menstrual disorders.
Measurement of the basal temperature: The basal temperature curve measured in the morning can provide information as to whether an irregular cycle is the sign of impaired egg cell maturation or a lack of ovulation.
Laboratory tests: The measurement of hormone concentrations (prolactin, estrogens, gestagens, thyroid hormones, etc.) in the blood is particularly important if an irregular cycle is due to hormonal disorders.
Imaging methods: Ultrasound, computed tomography (CT) and / or magnetic resonance tomography (MRT) can be used to show cycle-specific changes in the genital organs or to rule out tumors.

Treatment for irregular cycle

Treatment depends on the cause. If an irregular cycle is caused by diseases such as chronic adnexitis or polycystic ovary syndrome, the treatment of these diseases is paramount.

To stabilize the cycle, women can take hormone preparations (such as the pill).

The use of hormone preparations requires a medical examination.

Irregular cycle: you can do it yourself

You can do some things yourself to normalize an irregular cycle:

If stress and exhaustion are causing an irregular cycle, stress relief, regular rest breaks, and adequate (moderate) exercise can help. Walking or relaxation methods such as yoga, autogenic training or progressive muscle relaxation can help to normalize the hormone balance and thus the monthly cycle again.
In medicinal herbalism, an irregular cycle is regulated with the help of monk's pepper (chaste mud). In order to achieve a positive effect, a treatment lasting several months is recommended. Let an experienced therapist advise you.
Mud baths and mud packs (e.g. as part of a spa stay) can help if an irregular cycle is due to chronic adnexitis.

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