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Menstrual Irregularities

What are Menstrual Irregularities?

For most women, a normal menstrual cycle ranges from 21 to 35 days.  However, up to 14% of women have irregular menstrual cycles or excessively heavy menstrual bleeding.  Most abnormal uterine bleeding can be divided into anovulatory and ovulatory patterns:

Anovulatory: Irregular/infrequent periods with absent, minimal, or excessive bleeding.
Ovulatory: Periods that occur at regular intervals but are characterized by excessive bleeding or a duration of greater than 7 days.

The most common menstrual irregularities include:

Anovulatory Bleeding

Amenorrhea (absence of menstrual periods) Amenorrhea occurs when 1.) A woman does not get her period by age 16, or 2.) When she stops getting her period for at least 3 months and is not pregnant.
● Oligomenorrhea (infrequent menstrual periods) Oligomenorrhea occurs when periods occur more than 35 days apart.

Ovulatory Bleeding

● Menorrhagia (heavy menstrual periods) although anovulatory bleeding and menorrhagia are sometimes grouped together, they do not have the same cause and require different diagnostic testing.
● Prolonged menstrual bleeding: Bleeding that exceeds 8 days in duration on a regular basis.

Dysmenorrhea: Painful periods that may include severe menstrual cramps.

Additional menstrual irregularities include:

● Polymenorrhea: Frequent menstrual periods occurring less than 21 days apart
● Irregular menstrual periods with a cycle-to-cycle variation of more than 20 days
● Shortened menstrual bleeding of less than 2 days in duration
● Intermenstrual bleeding: Episodes of bleeding that occur between periods, also known as spotting

What causes Menstrual Irregularities?

Menstrual irregularities can be caused by a variety of conditions, including pregnancy, hormonal imbalances, infections, malignancies, diseases, trauma, and certain medications.  Visit your healthcare provider if you have questions or concerns regarding your menstrual cycle.


Treatment options vary by diagnosis.  After a correct diagnosis is established, treatment choices may be explored with your healthcare provider.

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