Irregular Menstrual Cycles: When to Seek Medical Advice

Menstrual cycle lasts three to four months?

Hello, doctor.
Since I started my period in the first year of junior high, my menstrual cycle has not been regular every month.
My mother said that this is normal at the beginning, but even after entering high school, I only had my period about four times a year, averaging once every 3-4 months.
Other articles I read mentioned that this irregularity is normal in the early stages.
However, I have now graduated from college and entered the workforce, and I still do not have a regular monthly cycle.
Aside from the long intervals between periods, there are no other abnormalities during my menstrual period; it lasts about 5-7 days, with a heavier flow in the first two days, then tapering off.
I believe my experience is similar to that of other women.
Should I seek medical attention?

Huang., 20~29 year old female. Ask Date: 2016/10/15

Dr. Huang Yiwen reply Obstetrics and Gynecology

Hello Ms.
Huang, your situation may be caused by individual physiological factors.
The main reason is likely due to chronic anovulation, which results in irregular menstrual cycles.
I recommend that you visit a gynecology clinic for an examination.
If a definitive cause cannot be identified, you may consider taking cyclical progesterone to regulate your menstrual cycle.
This approach can help prevent the long-term risks of endometrial hyperplasia or other pathologies.

Reply Date: 2016/10/15

More Info

Irregular menstrual cycles can be a common concern for many women, especially during the early years of menstruation. However, when these irregularities persist into adulthood, it may warrant further investigation. Based on your description, it appears that you have been experiencing irregular menstrual cycles since your first period, with cycles occurring every few months rather than on a monthly basis. While it is true that irregular cycles can be normal during the adolescent years, especially as the body is still adjusting to hormonal changes, the persistence of this irregularity into adulthood is something to consider seriously.

1. Understanding Irregular Cycles: Irregular menstrual cycles can be caused by a variety of factors, including hormonal imbalances, stress, significant weight changes, excessive exercise, or underlying medical conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or other endocrine issues. Given that you have not experienced any other symptoms such as severe pain, excessive bleeding, or significant changes in your overall health, it may seem less urgent. However, the absence of regular cycles can still indicate an underlying issue that may need to be addressed.

2. When to Seek Medical Advice: It is generally advisable to seek medical advice if you experience any of the following:
- Your periods are consistently more than 35 days apart.

- You have missed three or more consecutive periods.

- Your menstrual flow is excessively heavy or prolonged.

- You experience severe pain during your periods.

- You have other symptoms such as weight gain, hair loss, or acne, which could indicate hormonal imbalances.

3. Potential Tests and Evaluations: If you decide to consult a healthcare provider, they may recommend several evaluations to determine the cause of your irregular cycles. This could include:
- A thorough medical history and physical examination.

- Blood tests to check hormone levels, including thyroid hormones, prolactin, and androgens.

- An ultrasound to examine the ovaries and uterus for any abnormalities.

- A pelvic exam to assess any physical issues.

4. Management and Treatment Options: Depending on the findings, treatment options may vary. If a hormonal imbalance is identified, hormonal contraceptives may be prescribed to help regulate your cycles. Lifestyle changes, such as maintaining a healthy weight, managing stress, and regular exercise, can also play a significant role in regulating menstrual cycles.

5. Conclusion: While it is not uncommon for some women to have irregular menstrual cycles, especially in their late teens and early twenties, the persistence of this pattern into adulthood should not be overlooked. It is important to listen to your body and seek medical advice if you have concerns. A healthcare provider can help you understand your menstrual health better and address any underlying issues that may be affecting your cycles. Regular check-ups and open communication with your healthcare provider can help ensure that any potential problems are identified and managed early on.

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