Understanding hormonal issues associated with menstrual irregularities

Written by: Dr Dulmini Kariyawasam
Published: | Updated: 03/05/2024
Edited by: Karolyn Judge

Do you have period problems such as irregularity or infrequency? Leading diabetes, endocrinology, and general internal medicine consultant Dr Dulmini Kariyawasam discusses how they can be related to hormonal issues in this informative article.

Woman who experiences hormonal issues associated with menstrual irregularities

What are hormonal issues associated with menstrual irregularities?

Hormonal issues refer to disruptions in the normal balance of hormones in the body, which can lead to menstrual irregularities. These irregularities may include:

  • Amenorrhea: Absence of menstruation for several months.
  • Oligomenorrhea: Infrequent or irregular menstrual periods.
  • Heavy menstrual bleeding: Excessive or prolonged menstrual bleeding.
  • Polymenorrhagia: Frequent menstrual periods occurring less than 21 days apart.
  • Menorrhagia: Heavy menstrual bleeding that lasts for more than seven days or requires frequent changes of sanitary pads or tampons.
  • Dysmenorrhea: Painful menstrual periods, which may be accompanied by cramping and discomfort.



What causes hormonal issues leading to menstrual irregularities?

Several factors can contribute to hormonal imbalances and menstrual irregularities, including:

  • Polycystic ovary syndrome (PCOS): A common hormonal disorder characterised by elevated levels of androgens (male hormones) and insulin resistance, leading to irregular periods, ovarian cysts, and other symptoms.
  • Thyroid disorders: Conditions such as hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid) can disrupt the menstrual cycle by affecting hormone production.
  • Pituitary disorders: High prolactin, pituitary tumours affecting hormone secretion.
  • Hormonal contraceptives: Certain forms of birth control, such as hormonal contraceptives (pills, patches, injections), can cause changes in menstrual bleeding patterns.
  • Stress: Physical or emotional stress can impact the hypothalamic-pituitary-adrenal (HPA) axis, leading to hormonal imbalances and menstrual irregularities.
  • Weight fluctuations: Significant changes in body weight, whether weight gain or weight loss, can affect hormone levels and disrupt the menstrual cycle causing functional amenorrhoea.
  • Chronic conditions: Medical conditions such as diabetes, obesity, and adrenal disorders such as adrenal hyperplasia can interfere with hormone regulation and menstrual function.



How are hormonal issues associated with menstrual irregularities diagnosed?

Diagnosis of hormonal issues and menstrual irregularities typically involves:

  • Medical history: Your doctor will inquire about your menstrual history, including the frequency, duration, and intensity of your periods, as well as any other symptoms you may be experiencing.
  • Physical examination: A pelvic examination may be performed to assess the reproductive organs and check for any abnormalities.
  • Hormonal testing: Blood tests may be ordered to measure hormone levels, including LH/FSH, oestrogen, progesterone, testosterone, thyroid hormones, and others.
  • Imaging studies: Ultrasound imaging may be used to evaluate the ovaries and uterus for any structural abnormalities or cysts.
  • Perimenopause/menopause: Around the time of menopause periods will be irregular, either with longer cycles or even shorter cycles. This can also be associated with heavy bleeding. Other symptoms such as hot flushes and brain fog may also be associated with perimenopause.



How are hormonal issues associated with menstrual irregularities treated?

Treatment of hormonal issues and menstrual irregularities depends on the underlying cause and may include:

Hormonal therapy

Hormonal medications, such as birth control pills, hormone replacement therapy, or medications to regulate thyroid function, may be prescribed to restore hormonal balance and regulate the menstrual cycle.

Lifestyle modifications

Adopting a healthy lifestyle, including regular exercise, balanced nutrition, stress management techniques, and adequate sleep, can help improve hormone regulation and menstrual regularity.

Surgical intervention

In some cases, surgical procedures may be recommended to address underlying conditions contributing to menstrual irregularities, such as ovarian cyst removal or endometrial ablation.



Management of underlying conditions

Treating underlying medical conditions, such as PCOS, thyroid disorders, or diabetes, is essential for managing hormonal issues and restoring normal menstrual function.

Hormonal issues associated with menstrual irregularities can significantly impact a woman's quality of life and reproductive health.

If you're experiencing persistent or concerning symptoms related to menstrual irregularities, it is important to consult with a medical professional for proper evaluation and management. By identifying the underlying cause and implementing appropriate treatment strategies, hormonal balance can be restored, and menstrual regularity can be achieved, leading to improved overall health and well-being.




Concerned about how menstrual irregularities are affecting you? Arrange a consultation with Dr Kariyawasam via her Top Doctors profile.

By Dr Dulmini Kariyawasam
Endocrinology, diabetes & metabolism

Dr Dulmini Kariyawasam is a highly esteemed diabetes, endocrinology, and general internal medicine consultant in central London who specialises in polycystic ovary syndrome (PCOS), type 1 diabetes and technology and obesity, alongside hypoglycaemia, thyroid and adrenal gland disorders. She privately practises at London Bridge Hospital - part of HCA Healthcare and Guy's and St Thomas' Private Healthcare, while her NHS base is Guy’s and St. Thomas’ NHS Foundation Trust where she leads the young adult diabetes and endocrine services at Guy’s and St. Thomas’ Hospital.

Dr Kariyawasam is a fellow of the Royal College of Physicians, London, and holds a Masters in Diabetes and Endocrinology from King’s College London. She's actively involved in undergraduate teaching at King's College London Medical School where she is the teaching lead and a senior lecturer, ensuring the next generation of physicians are equipped with the necessary knowledge and skills in diabetes and endocrinology.

In addition to her clinical and educational work, Dr Kariyawasam is dedicated to research, with interests in managing diabetes during adolescence, supporting young adults with diabetes, and addressing hypoglycaemia.

She has won national awards for her innovative models of care for young adults and is a member of prestigious professional organisations including Diabetes UK, the American Diabetes Association, the British Endocrine Society, and the Society of Endocrinology.

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