Understanding Menstrual Irregularity

Clinically speaking, there are a number of conditions that fall under the umbrella of “menstrual irregularity.” Let’s take a look at the most prevalent forms of menstrual irregularity recognized in the world of reproductive health.

What is oligomenorrhea?

In reproductive medicine, when we talk about menstrual irregularity, we’re usually referring to oligomenorrhea—the medical term for having infrequent periods. Oligomenorrhea affects 13.5% of the population and can sometimes be caused by an underlying disorder, like hyperthyroidism or polycystic ovarian disease.

However, this type of irregularity most commonly results from stress and/or extreme, frequent physical exertion, as in the case of many athletes, dancers, and performers. Oligomenorrhea is characterized by:

• Menstrual cycles with more than 35 days between cycles
• Menses that occurs between 4 and 9 times per year
• Extremely scanty menstrual flow during periods

While you may occasionally ovulate with this condition, if left untreated, oligomenorrhea can lead to sub-optimal conditions for implantation of a fertilized egg into the uterine lining, infertility, and other damages to both your reproductive equipment and metabolic health.

Birth control is a common way of treating oligomenorrhea, but if you’re trying to get pregnant, lifestyle-related interventions (such as a decrease in intense physical exertion) and hormone therapy are some of the most efficacious strategies for getting back on track.

What is polymenorrhea?

Where oligomenorrhea refers to finicky, uneven menstrual cycles, polymenorrhea is characterized by frequent menses, with cycles lasting fewer than 21 days.

Polymenorrhea can make conception more difficult because:

• Ovulation rarely follows a consistent pattern.
• The luteal phase—when the uterine lining becomes nourished enough to maintain a fertilized egg—is cut short.

Fertility treatment for polymenorrhea is case-specific, so if it’s a concern for you, be sure to bring it up with your OBGYN.

What is amenorrhea?

Lastly, amenorrhea refers to the complete absence of a regular menstrual cycle. There are two types of amenorrhea:

• Primary amenorrhea – When someone 15 or older has not gotten her period.
• Secondary amenorrhea – Where an adult woman experiences the cessation of her period for a duration of 3 or more months.

Secondary amenorrhea can signal a failure to ovulate. Lifestyle factors, such as stress and certain kinds of medication, can lead to this condition, but it can also result from underlying hormonal dysregulation.

Understanding Ovulation Irregularity

Menstrual irregularities can cause ovulation irregularities, but issues with ovulation may also stem from anovulation. Anovulation is the clinical term for when an oocyte (an egg) is not released by the ovary.

Approximately 30% of infertility cases are due to anovulation, which may be caused by any of the following:

• Medication – Aside from some types of birth control, other classes of drugs can interfere with monthly ovulation. Various NSAIDs, steroids, psychotropic drugs, and even some herbs (such as St. John’s Wort and echinacea) can inhibit the hormonal balance required for a successful release of an egg.
• Low BMI – Excessive physical activity and/or low body weight can place an undue burden on your reproductive health. This is because being underweight hampers the pituitary gland’s production of LH (luteinizing hormone) and FSH (follicle-stimulating hormone), both of which nurture the egg’s growth and its dispensation by the ovary.
• Premature ovarian insufficiency – Normally, menopause begins sometime in your 40s and 50s, but premature ovarian insufficiency causes the ovaries to slow their estrogen production before this age. When this happens, ovulation rhythms slacken and periods occur irregularly or not at all.

Finally, PCOS, or polycystic ovary syndrome, is the single most common cause of anovulation.

What is PCOS?

PCOS is a hormonal imbalance that affects 1 in 10 women in their reproductive prime. This hormonal imbalance can affect ovulation in several ways:

• Too many androgens, considered “male” hormones, are produced in the ovary, while estrogen levels tend to be suppressed. The excess of androgen produces more follicles than normal (the small sacs responsible for holding and nurturing an egg as it matures). This makes each follicle less receptive to input from follicle stimulating hormones telling them to grow. With less FSH to go around, a single egg cannot ripen, and ovulation cannot occur.
• The excess of androgens can also lead to the formation of cysts on the ovary, which can hinder ovulation.

Researchers contend that PCOS is usually the result of a genetic mutation, but obesity has also been shown to augment the likelihood of its manifestation. In these cases, a doctor may recommend a healthy diet and regular exercise as part of a treatment plan.

PCOS can also be treated with birth control pills or progestin therapy.

Can you still menstruate if you experience anovulation?

Some women with anovulation may experience bleeding even though ovulation has not occurred. This is because insufficient levels of progesterone or estrogen during what’s supposed to be the “ovulation phase” of your cycle can cause bleeding.

However, because this bleeding is not due to the breakdown of an unfertilized egg and the shedding of the uterine lining, it’s not considered a period.

Can you conceive if you have irregular periods?

Fortunately, it is possible to conceive if you have irregular periods. Having difficulty with conception isn’t uncommon, and learning more about your unique cycle can only help.

While it’s crucial to consult with your OBGYN about any health concerns, there are some things you can do to understand your reproductive cycle, increase your likelihood of conceiving, and prep your body for a healthy pregnancy.

#1 Track Your Ovulation Cycles

If you’re trying to get pregnant with irregular menstrual cycles, your first order of business is to determine when ovulation is occurring.

There are four ways to gauge ovulation on your own:

• Take your basal body temperature – In women, BBT sees an acute uptick during ovulation by an average of half of a degree. By tracking your ovulation temperature daily, you’ll be able to verify you’ve ovulated and gain a clearer picture of your fertile window.
• Keep an eye on vaginal discharge – While it’s not the most glamorous way to track your ovulation schedule, paying attention to your discharge and cervical mucus after ovulation can tell you a lot about what’s going on in your reproductive cycle. Just before ovulation, the discharge will be clear and viscous, resembling raw egg whites—a mechanism your body uses to help along with any sperm who come to court your egg.
• Examine the position of the cervix – This method requires the most hands-on effort of the bunch, but the positioning and feel of your cervix is an excellent indicator of whether ovulation has occurred. During ovulation, the cervix softens and creates a small aperture to receive sperm; when you aren’t ovulating, it will remain less pliable and closed.
• Take an ovulation predictor test – Many women opt for over-the-counter ovulation predictor tests to detect when they’re ovulating. These require you to urinate on a stick during the time of the month you expect to be ovulating. Once luteinizing hormone is detected in your urine, you can expect to ovulate within the next 24 to 36 hours (so you can go ahead and get busy with your partner). However, it’s important to note that women with PCOS often yield inaccurate readings with this method because their hormonal imbalances cause naturally high baseline levels of LH, resulting in false positives.

#2: Hone in on Your Diet

Aside from paying attention to your monthly cycle, diet and exercise play a major role in establishing hormonal equilibrium, decreasing ovulation cramps, and supporting healthy ovulation cycles.

To increase your chances of fertility, consider:

• Reducing refined sugars and processed foods and opting for whole food-based meals.
• Ditching low-carb diets, which can cause missed periods or irregular cycles, and helping yourself to healthy carbs, such as brown rice, quinoa, and oats.
• Including hormone-helping healthy fats, like omega-3 rich oils, fish, nuts, and avocados, in every meal.
• Taking a folate supplement, which has been shown to steady periods, support regular ovulation, and improves fertility outcomes.

#3: Prioritize De-Stressing

Reducing stress is always a promising avenue for improving health outcomes across the board, including your menstrual health and fertility.

Getting enough sleep, going on walks, and taking some time away from screens are all tremendously beneficial for managing chronic, low-grade anxiety.

Remember, stress is a physical phenomenon as much as it is a psychological one, so taking care of your physical body as well as your mental state can yield tremendous gains for your fertility.

Have A Mindful Pregnancy With SneakPeek

By becoming more aware of your unique and irregular menstrual cycle, you can take steps to ensure you’re ovulating consistently and increase your chances of conceiving a precious baby boy or girl. When that happens, you can bring the same level of awareness to your pregnancy with the help of SneakPeek.

The SneakPeek At-Home Early Gender Prediction Kit is the #1 OBGYN-recommended gender test on the market today. By collecting a DNA sample in the comfort of your own home, you can learn the sex of your baby as early as 6 weeks into your pregnancy—months before an ultrasound can provide insight—and with clinically-proven over 99% accuracy¹. In fact, if your results don’t match your baby’s gender, we’ll provide you a full refund.

Choose SneakPeek to join you and your baby-to-be on the next step of your journey.