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Irregular Menstrual Cycles. What’s Up With That?

J.B.

What is an irregular menstrual cycle?  Well, that kind of depends on who you ask, but the medical consensus seems to be that a “normal” menstrual cycle lasts 28 days, give or take seven days.  A cycle is considered to be irregular if it occurs more often than every 21 days or if bleeding goes on longer than 8 days.  Early or late periods, and missed periods are also considered to be irregular.

How common is an irregular menstrual cycle?  According to Dr. Amy Autry, Professor of Obstetrics-Gynecology and Reproductive Sciences at the University of California, “at least 30% of women have irregular periods during their childbearing years”.  A 2011 report published in the Journal of Clinical Endocrinology and Metabolism confirms that many women occasionally experience irregular periods all throughout their reproductive years.

But what causes irregular periods?  Well, like most things, there isn’t just one answer.  The menstrual cycle can be influenced by a number of factors.

Uterine abnormalities such as fibroids or polyps can cause irregularities.  Endometriosis, a condition when the lining of the uterus grows in other places such as the ovaries or fallopian tubes or even other parts of the body, can cause excessive menstrual bleeding and other symptoms.

Out-of-kilter hormones are a usual suspect in irregular periods.  In an article published by the Society for Menstrual Cycle Research, Dr. Lara Briden says that “thyroid hormone affects every cell in the body” and that hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) affects menstruation.  The U.S. Department of Health & Human Services agrees, saying “too much or too little thyroid hormone can make your periods very light, heavy, or irregular”.  Adrenal glands can also play a part.

The four “female hormones” -- estrogen, follicle-stimulating hormone, luteinizing hormone, and progesterone -- regulate your menstrual cycle. Women’s Health Connecticut describes how estrogen acts to build up the uterine lining and also loosens the support for the build-up in the event of non-pregnancy so that menses can occur.  The follicle-stimulating hormone is secreted by the pituitary gland to promote the formation of the egg.  Follicles are small sacs of fluid found on the outside layer of the ovaries.  These follicles contain immature eggs (called “oocytes”).  Several follicles will begin to develop with each cycle, but generally just one of them will continue to grow and produce a matured egg. The luteinizing hormone, also secreted by the pituitary gland, causes the follicle to rupture and release the matured egg.  Once the egg has been released, the ruptured follicle secretes progesterone.  If no pregnancy has occurred, the progesterone level falls and, working with the estrogen, helps the uterine lining to separate and menstruation to begin.

An imbalance of reproductive hormones can create a condition known as PCOS (Polycystic Ovary Syndrome), an ailment that can lead to missed or irregular periods and ovarian cysts.  Health issues such as diabetes, sleep apnea, high blood pressure and others have been associated with PCOS, although it is unknown if PCOS causes these issues or if these issues cause the PCOS.

Stress can have a profound influence on hormonal production and balance.  Bear in mind that “stress” is not limited to emotional factors such as anxiety.  There are also physical stressors that can have a significant effect on the body such as extreme weight loss or weight gain, excessive exercise and its reverse (lack of exercise), lack of sleep, and schedule disruptions like traveling across time zones.  There are also environmental stressors, some of which you may not have suspected.  For instance, phthalates, known endocrine disruptors, are contained in a number of common consumer products including makeup, hairsprays, and nail polish.  Plastics often contain estrogenic chemicals (chemicals that mimic estrogen).  Diet can also be a factor in hormonal balance, and particularly consumption of “toxic” foods such as meat from animals that were given hormones to promote their growth, GMO foods, and (sadly, for those of us with a ferocious sweet tooth) sugar.

How can you entirely avoid all these physical stressors?  Unless you’ve bought a remote island that doesn’t contain any plastics, where having no makeup and frizzy hair is okay with you and where you’re growing your own food, you probably can’t.  But, if a private island isn’t in the budget, you may be able to remove some of the more harmful elements from your diet and from your environment.  Elimination of some of the worst offenders can not only help to smooth out and regulate your menstrual cycle,  it can also promote better general health and outlook (always a good thing).

And remember that not every woman’s menstrual cycle occurs with the precision of a NASA launch.  Some irregularities are harmless and insignificant.  But if you think you have cause for concern, your best bet is to consult your health practitioner.

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