Irregular Menstrual Periods

Introduction

• Description: Menstrual cycles that do not follow a rhythmic pattern or have a pattern significantly differing from that expected as “normal” are considered irregular. This represents a special form of dysfunctional (abnormal) uterine bleeding.

• Prevalence: 10%–15% of all gynecologic visits; annual prevalence rate of approximately 5%.

• Predominant Age: Reproductive age; highest in adolescents and patients who experience climacteric changes.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Anovulation or oligo-ovulation, climacteric or menopause, hypogonadism (including exercise induced: excessive, associated with low body weight and anovulation), excess estrogen (obesity, polycystic ovary disease, exogenous estrogen), elevated prolactin, psychosocial conditions (anorexia, bulimia, stress), chronic illness, renal or hepatic failure, thyroid disease.

• Risk Factors: Those associated with possible causes.

Signs and Symptoms

• Irregular menstrual interval

• Variable character of menstrual flow

Diagnostic Approach