Irregular Periods

Overview#

A normal menstrual cycle ranges from 21 to 35 days, with bleeding lasting 2–7 days. Periods are considered irregular when cycles consistently fall outside this range, vary by more than 7–9 days from month to month, are missed for 3+ months (amenorrhoea), or involve very heavy or very scanty bleeding. Menstrual irregularities affect an estimated 15–25 % of Indian women of reproductive age.

In India, PCOS (Polycystic Ovary Syndrome) and thyroid disorders are the two most common medical causes. Cultural stigma around menstruation often delays women from seeking timely care, which can lead to complications like infertility, anaemia, and endometrial problems.

Common Causes#

1. Polycystic Ovary Syndrome (PCOS) — the most common hormonal disorder in young Indian women; causes irregular or absent periods, acne, weight gain, and excess hair growth.
2. Thyroid disorders — both hypothyroidism (heavy, frequent periods) and hyperthyroidism (light, infrequent periods) disrupt the menstrual cycle.
3. Stress and lifestyle factors — chronic stress, excessive exercise, drastic weight loss, or significant weight gain can disrupt ovulation.
4. Premature ovarian insufficiency — early decline of ovarian function before age 40, causing irregular periods and eventually menopause.
5. Hyperprolactinaemia — elevated prolactin hormone (from pituitary issues or medications) suppresses ovulation and periods.
6. Uterine fibroids or polyps — benign growths in the uterus causing heavy, prolonged, or irregular bleeding.
7. Perimenopause — the transitional period before menopause (usually starting in the mid-40s) causes increasingly irregular cycles.

Associated Symptoms#

Irregular periods may be accompanied by acne, hair fall, excess facial or body hair (hirsutism), weight gain (especially abdominal), mood swings, pelvic pain, heavy clotting, or difficulty conceiving.

Home Remedies & Self-Care#

• Maintain a healthy weight — both underweight and overweight disrupt hormonal balance.
• Exercise regularly — 30–45 minutes of moderate activity most days helps regulate cycles.
• Manage stress through yoga, pranayama, or mindfulness meditation.
• Track your periods using an app or calendar to identify patterns (useful for your doctor).
• Eat a balanced diet rich in iron (to compensate for heavy bleeding), omega-3 fats, and whole grains.
• Limit processed foods, excess sugar, and refined carbohydrates (especially if PCOS is suspected).

When It's Serious#

See a gynaecologist promptly if:

• Periods have stopped for 3 or more months (and you are not pregnant, breastfeeding, or menopausal).
• Bleeding lasts more than 7 days or soaks more than one pad per hour (menorrhagia).
• You notice intermenstrual bleeding or bleeding after intercourse.
• Severe pelvic pain accompanies menstrual irregularities.
• You are trying to conceive and periods have been irregular for over 6 months.
• Periods become irregular after age 40 with hot flushes (possible early menopause).

Diagnosis & Tests#

Your doctor may recommend:

• Thyroid Profile (TSH, T3, T4) — thyroid disease is a common, treatable cause.
• Hormonal panel (LH, FSH, oestradiol) — to assess ovarian function and ovulation.
• Serum prolactin — to rule out hyperprolactinaemia.
• Testosterone & DHEAS — elevated in PCOS.
• Fasting insulin & blood glucose — to check for insulin resistance associated with PCOS.
• CBC & iron studies — to detect anaemia from heavy periods.
• Pelvic ultrasound — to check for polycystic ovaries, fibroids, polyps, or endometrial thickening.
• Endometrial biopsy — if abnormal bleeding occurs after age 40 (to rule out endometrial hyperplasia).

When to See a Doctor#

Do not dismiss irregular periods as "normal." See a gynaecologist if cycles are consistently irregular, very heavy, very painful, or if you are having difficulty conceiving. Early diagnosis of PCOS and thyroid disorders can prevent long-term complications.