Who hasn't experienced it: Your period starts early, occurs more frequently than usual, stops altogether, or is heavier or lighter? Almost every menstruating woman has experienced these symptoms at some point. All of these deviations from the normal monthly cycle are collectively referred to as menstrual irregularities. But what types do they actually exist, what are the causes, and what can you do about them? We'll explain all of this to you in this blog post.
Symptoms and forms of cycle disorders
Generally, menstrual irregularities can be divided into two categories. If your period occurs more frequently or less frequently, this is referred to as rhythm disturbances. In short, the length of your cycle changes. These include the following types:
Amenorrhea: This refers to the complete absence of menstruation. This is the most common form of menstrual irregularity. A distinction is made between primary and secondary amenorrhea. Primary amenorrhea occurs when menstruation has not occurred after the age of 16. Secondary amenorrhea affects anyone who has already had a period but then stops for more than three months. The two forms differ in their causes, but more on that later.
Oligomenorrhea: In this form of menstrual disorder, your cycle lasts longer than normal, namely approximately 35 days.
The counterpart to oligomenorrhea is polymenorrhea . Bleeding occurs more frequently and the cycle is shorter than 25 days.
The well-known spotting or intermenstrual bleeding also falls under the group of rhythm disorders and can occur either before, after or during menstruation.
If your bleeding intensity deviates from normal, it's a type disorder. These include the following types:
- If your bleeding is exceptionally heavy, it's called hypermenorrhea. A good indicator of excessive bleeding is using more than five pads or highly absorbent tampons per day.
- In contrast, hypomenorrhea is a light bleeding where you need fewer than two pads or low-absorbency tampons per day.
- If your bleeding lasts longer than six days, it is called menorrhagia, or unusually long periods.
- Shortened bleeding that lasts less than three days is called brachymenorrhea.
But don't panic! Not all deviations from the norm are cause for concern and warrant a visit to the doctor. You should see a doctor if...
… you are older than 16 years and have not had a period yet.
… the intervals between your periods become permanently shorter or longer.
… your bleeding is uncomfortably heavy or lasts so long that it causes you suffering and even weakens your body.
...your period is late and you are not pregnant and are not breastfeeding.
…you have bleeding even though you have already gone through menopause.
…you just want to play it safe.
Causes of menstrual disorders
The causes are as diverse as the symptoms themselves. Various illnesses, changes in lifestyle, hormonal imbalances, or even simply stress: all of these can seriously disrupt your cycle. Below, we'll summarize the most common causes for the aforementioned types.
Primary and secondary amenorrhea
The most common causes of primary amenorrhea are physical. These include:
- Malformations of the genitals
- Hormonal disorders
- congenital anomalies of the chromosomes or
- Ovarian dysfunction.
In contrast, secondary amenorrhea is caused not only by physical triggers but also by psychological factors. Stress, in particular, plays a major role in the absence of periods. It can affect both the hormonal and nervous systems, thus leading to a lack of bleeding. Competitive sports, extreme situations, and even stays abroad associated with climate change can also trigger secondary amenorrhea. Physical causes can also be the trigger. These include:
- strong weight fluctuations or
- severe weight loss
- Metabolic diseases
- taking various medications or
- discontinuation of hormonal contraceptive methods.
Oligomenorrhea
A prolonged cycle is often associated with slow or insufficient follicle maturation. This delays ovulation, and consequently, your period also starts later. Delayed follicle maturation is caused by insufficient production of various hormones that influence follicle maturation. These hormonal imbalances can be caused by the following triggers:
- Polycystic ovary syndrome (PCOS)
- Ovarian cysts
- Malformations of the genital organs
- Impairment of the areas of the brain responsible for hormone production (e.g. due to stress, mental illness, eating disorders or competitive sports)
Polymenorrhea
In this case, follicle maturation is again one of the triggers. However, the maturation phase in polymenorrhea is shorter than usual. This can be caused by certain life phases in which hormonal processes in the body change, such as after the first menstrual period or at the onset of menopause.
A second cause of polymenorrhea can be corpus luteum deficiency. A corpus luteum develops from the egg cell membrane after ovulation and then produces the hormone progesterone, which prepares the uterine lining for possible implantation of the fertilized egg. If fertilization does not occur, progesterone production stops after a certain period, and bleeding begins. However, if too little progesterone is produced by the corpus luteum, menstruation begins earlier.
Hypermenorrhea
If your period is unusually heavy, it may be due to your uterus not being able to contract properly. The muscles of the uterus allow the lining of the uterus to loosen and shed. The contraction also helps stop the bleeding by allowing the blood vessels in the uterus to close again.
If there is a benign growth (fibroid) in the uterus or a polyp in the lining of the uterus, contractions may be impaired and bleeding may be heavier. The following conditions can also cause unusually heavy periods:
- Endometriosis
- Endometritis
- Hormonal disorders
- Benign or malignant tumors in the uterus
- Malformations of the uterus
Hypomenorrhea
The following diseases or factors can cause a rather light bleeding:
- Inflammation of the uterus (endometritis)
- Too much or too little body weight
- Ovarian dysfunction
- Hormonal contraception with progestogens
- Impending menopause
- Physical stress situations
- competitive sports
Menorrhagia
The most common cause of prolonged menstrual bleeding is contraction disorders of the uterine muscles, which prevent the muscles from contracting properly during menstruation. The IUD can also be a cause of menorrhagia. In frequent cases, hypermenorrhea occurs alongside prolonged bleeding. Other causes that can trigger menorrhagia include:
- uterine inflammation
- Blood clotting disorders
- Metabolic diseases
- Ovarian inflammation
Brachymenorrhea
As in so many cases, hormonal changes trigger shortened periods. However, a congenital change in the uterine lining can also be the cause of brachymenorrhea.
Therapy for menstrual disorders
The specific treatment for your menstrual irregularities depends on the triggers, the type, and your individual life stage. Hormonal causes are often responsible for rhythm or type disturbances. In these cases, the respective menstrual irregularities can be treated with hormones. If the cause is organic, these can often be corrected surgically. It is fundamentally important that you describe your problem to your doctor as precisely as possible. This supports a correct diagnosis and ultimately the treatment. However, before any treatment, you should definitely rule out pregnancy.
Prolonged or absent cycles
As you've already learned, there are a variety of causes that can trigger this. For example, if you suffer from polycystic ovary syndrome, hormone therapy is necessary. However, if an eating disorder or psychological stress or strain is behind the menstrual irregularities, these triggers must be specifically addressed. In some cases, psychotherapy may also be necessary. Consult your doctor for advice.
Shortened cycles
This type of menstrual disorder doesn't always require treatment. However, if you suffer from frequent bleeding or have developed anemia as a result of heavy blood loss, hormone therapy can also help.
Treatment of mild or severe bleeding
Even in the case of light menstrual bleeding, treatment is not always necessary. If you are trying to conceive and the light bleeding is caused by an ovarian dysfunction, hormone therapy is required to induce ovulation.
The treatment of heavy menstrual bleeding depends on the underlying cause. If there is corpus luteum deficiency, progestin-containing medications are necessary. If you suffer from a blood clotting disorder, this is treated with anticoagulant medications.
Shortened or prolonged menstrual bleeding
Shortened bleeding that lasts no longer than 1.5 days often has hormonal causes. Treatment isn't always necessary. However, if stress or other physical causes are behind it, these must be treated separately.
If your bleeding is unusually prolonged due to fibroids or polyps, these can usually be removed surgically. Blood clotting disorders can also be treated with medication.
Always seek medical advice
Important note: This article contains only general information and should not be used for self-diagnosis or treatment. It is not a substitute for a consultation with a doctor.
Normally, blood is red, although all shades from light red to dark red to almost brownish-black are completely normal.
Blood reveals a lot about health and hormone levels. A grayish-red color, for example, can indicate an infection or disease.
During a healthy period, the blood is a bright red, although it may be lighter on heavier days and darker at the beginning and end.
Very light blood can be caused by low estrogen levels, which can be caused by stress, competitive sports or diets, but also by hormonal contraceptives such as the pill.
Yes, there is no need to worry, as brown blood is simply older blood that flows out of the body more slowly.
A very dark menstruation indicates that the blood is flowing slowly, reacting with oxygen and darkening.
Implantation bleeding is usually very light to pink and significantly lighter than a period.
This varies from person to person. The first period can be very light and brownish, but it can also be clearly visible as red blood.
The discharge may appear whitish to yellowish and its consistency is thick.
Postpartum bleeding is initially deep red and quite heavy. It also contains tissue debris. After the first week, the lochia subsides and becomes brownish, finally becoming whitish and stopping completely after about six weeks.
When menstruation returns after pregnancy, it has the typical red hue in its broad spectrum that you already know.
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