Irregular Periods: Causes and Diagnostic Tests - Obstetrics and Gynecology

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Irregular menstrual periods can be a source of concern for many women, and understanding the underlying causes is essential for effective management. In your case, experiencing prolonged menstrual bleeding for over two weeks, followed by a short interval before the next period, suggests a potential disruption in your menstrual cycle. This could indeed be indicative of hormonal imbalances or other underlying conditions.


Causes of Irregular Periods
1. Hormonal Imbalances: The menstrual cycle is regulated by a complex interplay of hormones, including estrogen and progesterone. Any disruption in these hormones can lead to irregularities. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders (hypothyroidism or hyperthyroidism) can significantly affect menstrual regularity.

2. Uterine Fibroids: These are non-cancerous growths in the uterus that can cause heavy bleeding and prolonged periods. While fibroids can develop over time, it is generally unlikely for them to grow significantly within just 2-3 months. However, if they were already present, they could cause changes in your menstrual pattern.

3. Endometrial Issues: Conditions such as endometriosis or endometrial hyperplasia can lead to irregular bleeding. Endometriosis, in particular, can cause pain and heavy bleeding during periods.

4. Stress and Lifestyle Factors: High levels of stress, significant weight changes, excessive exercise, or changes in diet can also impact your menstrual cycle.

5. Medications: Certain medications, including hormonal contraceptives, can cause changes in menstrual patterns. If you have recently started or changed any medications, this could be a contributing factor.


Diagnostic Tests
When you visit a larger hospital or a specialized clinic for evaluation of irregular periods, doctors typically perform a series of diagnostic tests to determine the underlying cause. These may include:
1. Blood Tests: Hormonal levels (such as estrogen, progesterone, FSH, LH, and thyroid hormones) are often checked to assess for imbalances. A complete blood count (CBC) may also be performed to check for anemia, which can result from heavy menstrual bleeding.

2. Pelvic Ultrasound: This imaging test helps visualize the uterus and ovaries to check for abnormalities such as fibroids, cysts, or other structural issues.

3. Endometrial Biopsy: If there are concerns about the lining of the uterus, a biopsy may be performed to check for abnormal cells or hyperplasia.

4. Hysteroscopy: In some cases, a hysteroscopy may be performed to directly visualize the inside of the uterus and obtain tissue samples if necessary.

5. Thyroid Function Tests: Given the role of thyroid hormones in regulating the menstrual cycle, tests to assess thyroid function may be included.


Conclusion
In summary, irregular menstrual periods can be caused by a variety of factors, including hormonal imbalances, structural abnormalities like fibroids, and lifestyle influences. It is essential to follow up with a healthcare provider, especially if the irregularities persist. They can guide you through the necessary diagnostic tests to identify the underlying cause and recommend appropriate treatment options. If you suspect that you may have fibroids or any other condition, discussing your symptoms and concerns with your doctor will help in determining the best course of action. Remember, early diagnosis and management can significantly improve your quality of life and menstrual health.