What Are the Causes of Irregularly Menstrual Periods?

QUESTION: Though most of my girl friends confide that their monthly periods
are like clockwork, mine are never on time, never seem the same, and seem all
wrong. I am becoming very anxious and wonder if there is anything you can
tell me about my condition. What can be done to help me?
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ANSWER: It's hard to tell from your question exactly what the problem is. It
sounds like you're complaining of irregularly spaced menstrual periods. If
that's the case, you and your doctor will probably want to evaluate whether
you are ovulating properly, since normal menstrual bleeding follows ovulation
by two weeks if fertilization does not occur.
There are a variety of ways to determine whether you are ovulating. Many
women identify a change in the cervical mucous when ovulation occurs. Some
women spot slightly and feel a pain in the lower abdomen when the ovary
releases its monthly egg. This has been given the descriptive name
of "middleschmertz" ( or "middle pain").
Basal body temperature rises by about 0.5 degrees F. at ovulation, and
remains elevated until menstrual bleeding begins. Taking your temperature
each morning with a basal body temperature thermometer, carefully following
its directions, will help to tell you whether you are ovulating.
There are also several self-test kits on the market which, when used
properly, can tell you whether you are ovulating.
If your doctor feels your problem warrants more investigation, he may
perform blood tests to check your hormone levels. Hormonal therapy can be
ordered to solve the problem, but hormones should be prescribed carefully.
If you're not ovulating, what could the problem be?
Stress, the culprit for so many other ills, can shut down ovulation.
Emotional stress and physical stress, such as that induced by extreme exercise
or illness, can change your hormonal levels enough so that ovulation is often
stopped until the problem is resolved. Women with anorexia nervosa often stop
ovulating.
Obese women often stop ovulating until they lose weight. Body fat can
produce estrogen, and the excess upsets the body's hormonal balance. The
result is no ovulation, irregular periods and an increased risk for cancer of
the lining of the uterus.
Women with abnormal thyroid function, especially those with a low thyroid
production, often do not ovulate. Treatment with thyroid medication usually
solves this problem.
Some women who do not ovulate have polycystic ovaries. Polycystic
ovaries are enlarged and contain many partially mature but unreleased eggs.
Drug therapy can usually correct this problem.
Tumors of the ovary or adrenal glands may cause ovulation problems, but
they're rare. If no other problems are found, this possibility should be
checked.
Not ovulating or irregular ovulation obviously causes infertility
problems. Ovulation problems that are causing infertility can sometimes be
treated successfully with hormonal therapy.
As you can see from my answer, irregular periods can be more than just a
nuisance. If you are experiencing irregular menstruation, you should be
thoroughly and completely evaluated, because menstrual problems may often be a
signal that something else is wrong.