Irregular periods: what and why

Written by: Dr Marina Fernando
Edited by: Sarah Sherlock

A passage of right for women, eventually the day will come when the period arrives. Although, the menstruation cycle is not always regular. To make it easy to understand what a regular menstruation is versus irregular and what causes them, expert consultant obstetrician and gynaecologist Dr Marina Fernando has provided us with the important information.


irregular menstruation


What is a regular menstrual cycle?

In women’s health, the common age of young girls starting their periods in the UK is about 10 to 11 years old. One should have a menstruation, which is a period, every month and the cycle can vary between 28 days to 30 days. That’s what we call a menstrual cycle.



Is it important to track my menstrual cycle?

It is definitely not encouraged to track a menstrual cycle. However, it is a recommendation just to be aware of your last menstrual period if you’re sexually active, certainly. And sometimes, it is useful to know when your periods are expected so that if can fit into your lifestyle.



What are the most common causes of irregular menstruation?

When you start having your periods as a young girl, a very common phenomenon is irregular periods. This is exactly what happens when the body is starting to really release oestrogen and progesterone. Until it identifies to a cyclical rhythm, you will have irregular hormonal levels within the body, which can lead to irregular periods. That’s one of the commonest reasons.


Now, when you are in your 20s and 30s, one of the other causes of irregular periods is what we call polycystic ovarian syndrome (PCOS). This is a condition where once again the hormonal balance is interrupted because of the ovarian function and the hormonal imbalance, and this can lead to having no periods or irregular cycles which women have on top of other symptoms. One of the other causes is when women have pathologies, which can be different things such as fibroids or polyps disrupting the lining of the womb, the cervix, or within the uterine cavity. Certainly, this can cause bleeding within your period cycles. So, to you and me it might look like an irregular cycle, however, what is actually happening is you’re bleeding because of pathology disrupting the normal anatomy.



How much irregularity is normal in menstruation? When should I see a doctor?

It is normal and good practice for you to at least have three to four periods a year. If you’re not having regular periods and you’re not shedding your endometrium three to four times a year, you certainly need to see a gynaecologist. Also, if you continue to have irregular periods, this can affect your day-to-day needs and it can also affect fertility. Once again, depending on where you are within your age groups and your requirements, in the absence of menstruation you are certainly not ovulating; so, this can delay your fertility. This is one of the commonest reasons I see women.



How can irregular menstruation be treated?

Irregular menstruation can be treated in many ways depending on the underlying cause. One of the commonest ways of regulating an irregular period is starting a combined oral contraceptive pill or a progesterone-only pill. What it does is take away the control and the hormonal function of your body; it regulates it by artificially giving you the medication of oestrogen and progesterone and induces the shedding of the endometrium. The other well-known way is by having a coil which is made out of hormones, and there are many on the market. What it does is basically radiates the endometrium within the uterine cavity and prevents irregular bleeding, and protects the lining of the womb, preventing it building up too much which can lead to unnecessary conditions. This gives the women the authority of leading a lifestyle without worrying about irregular periods.



If you think you may be experiencing irregular menstruation cycles or would like more information, you can go to Dr Fernando’s profile and book a consultation.

By Dr Marina Fernando
Obstetrics & gynaecology

Dr Marina Fernando is a leading consultant obstetrician and gynaecologist in London who has over 15 years of experience.

Her areas of specialist expertise include acute gynaecology, early pregnancypostmenopausal complications, contraception and high-risk obstetrics. Furthermore, she regularly performs numerous procedures including hysteroscopy, colposcopy and the application of contraception

Dr Fernando is dedicated to providing personalised and safe obstetric care for mothers and is keen to individualise each mother’s experience. Having worked in London throughout her career, she is confident in caring for women from diverse ethnic backgrounds and understands their cultural needs and maternal choices. 

Furthermore, she is the outpatient hysteroscopy lead and quality improvement safety lead at Homerton Hospital. She holds the regional lead position in London as the quality improvement lead at UCLPartners (Academic Health Science Network) and has successfully led improvement programmes in maternity such as PReCePT (Prevention of Cerebral Palsy in Preterm babies) and BSOTS (Birmingham Symptom specific Obstetrics Triage System) in London and Essex.

She is involved in undergraduate and postgraduate teaching and regularly showcases her obstetrics and gynaecological work and research in national and international platforms.

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