Irregular Menstrual Periods: Causes and Treatments

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If you’re not sure when your next menstrual period is coming, or you’re having a tough time getting pregnant, there is good news. Menstrual irregularities and fertility problems can often be corrected by managing a hormonal imbalance with medication and lifestyle changes.

Understanding Your Menstrual Cycle

During a normal menstrual cycle, an egg is released from one of your ovaries during ovulation. If the egg is not fertilized by a sperm, then changing hormone levels send your body a signal to shed the blood and tissues that line your uterus. This bleeding typically lasts about five days. Then, the monthly cycle repeats itself.

But some women have what is called abnormal uterine bleeding—another term for irregular periods—which can happen for a variety of reasons, from stress and lifestyle factors, to more serious underlying medical conditions.

PCOS: A Frequently Overlooked Diagnosis

Polycystic ovary syndrome (PCOS), also called Stein-Leventhal syndrome, is the leading cause of menstrual irregularities and infertility in women. It is very common—affecting an estimated 15-20% of reproductive-age women. It is also one of the most under-diagnosed conditions affecting women’s health. Fewer than half of women with PCOS are properly diagnosed.

What Causes PCOS?

Women with PCOS have too many male hormones, or androgens, and lower-than-average levels of female hormones. As a result, cysts often form on the ovaries. These fluid-filled sacs can interfere with egg release, or ovulation, causing irregular periods and fertility problems.

PCOS can also cause other issues, ranging from acne and facial hair to obesity and diabetes. In fact, more than half of women with PCOS will develop type 2 diabetes or pre-diabetes before the age of 40. They are also at higher risk of endometrial cancer, high blood pressure, high cholesterol, and heart attack.

Managing PCOS

Getting symptoms under control though integrative therapies, lifestyle changes, or medication helps reduce the risk of serious complications.

The most important strategy to address all symptoms of PCOS is to improve your diet, increase physical activity, and lose weight. These steps can help lower blood sugar levels, improve the body’s use of insulin and normalize hormone levels. And for any woman, they are important steps toward a happier, healthier life.

Medication Solutions

Metformin is a widely used diabetes drug that is also useful in managing PCOS symptoms. Metformin controls blood sugar, so it helps reduce the risk of diabetes, and may help women with PCOS lose weight and reduce their cholesterol levels. It may also help improve fertility by encouraging ovulation.

For women who don’t want to become pregnant, birth control pills can regulate menstrual cycles and reduce acne. It’s important to talk to your doctor about the risks and benefits of the various types of birth control hormones. Anti-androgen medications, which lower male hormones, can be used alone or with birth control pills to help treat acne, excess hair on the face and body, and hair loss on the head.

Some solutions are less well known. The journal Gynecological Endocrinology recently published an analysis of dietary supplements, or nutraceuticals, for PCOS. They found that a supplement called Inositol (sometimes called vitamin B8 although it’s not a true vitamin) looks very promising.

A variety of other dietary supplements might also be useful in helping treat PCOS-related symptoms such as insulin resistance, infertility and mood disorders. Talk to your doctor to learn the best option for you.

author name

Hyasmine M. Charles, MD

Hyasmine M. Charles, MD, is a physician with Lancaster General Health Physicians Women’s Internal Medicine.

Education: A graduate of the Penn State University College of Medicine and the residency program at the University of Rochester, Dr. Charles completed her fellowship at the University of Pittsburgh. She is board certified in internal medicine.

Schedule an Appointment Call: 717-544-0700

About LG Health Hub

The LG Health Hub features breaking medical news and straightforward advice to help individuals of all ages make healthy choices and reach their wellness goals. The blog puts articles by trusted Lancaster General Health clinical experts, good 'n healthy recipes, videos, patient stories, and health risk assessments at your fingertips.


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