Abnormal Uterine Bleeding secondary to Hormonal Imbalance

Absent or Irregular Periods

Ambulatory Care,Emergency Medicine,Reproductive

Written by the doctors and editors at UpToDate
What are absent or irregular periods? — Absent or irregular periods are periods that do not happen at all or that happen less than 6 to 8 times a year. If a woman does not get her period for a while, it might be because she is pregnant. Or in some cases, it might be that she has a medical condition that affects her reproductive system.
What causes absent or irregular periods? — Absent or irregular periods can be caused by:
Pregnancy
PCOS (which stands for "polycystic ovary syndrome") – PCOS is the most common cause of irregular periods. In women with this condition, the ovaries make too much male hormone. This can disrupt a woman's periods and cause excess facial hair, acne, and problems with weight.
A decrease in your body's energy supply – This can result from exercising too much, being very stressed, having an eating disorder, or burning more calories than you take in.
Too much prolactin – Prolactin is a hormone made in the "pituitary gland", which is a small organ at the base of the brain.
Early menopause – Menopause is the time in a woman's life when she naturally stops having periods. Menopause usually occurs between the ages of 45 and 55. But in some women, menopause comes early – before the age of 40. Early menopause happens when the ovaries run out of eggs earlier than normal.
Certain types of hormonal birth control – Some forms of birth control can cause absent or irregular periods. This is most common with those that contain only the hormone progestin. Examples include the progestin-only pill (sometimes called the "minipill"), the implant, and hormone-containing intrauterine devices (IUDs). It is also common with birth control pills that have a lower dose of estrogen. It does not mean the pill is not working, as long as you are taking it every day.
Should I see a doctor or nurse? — See your doctor or nurse if:
You are older than 15 and still have not had your period
You used to get periods, but you have not had a period for more than 3 months
Your periods happen more than 45 days apart
What other symptoms should I watch for? — Make sure to tell your doctor if you:
Think you might be pregnant
Have family members with irregular periods
Have bad acne or hair on your chest or face
Have gained weight and are having trouble losing it
Have hot flashes, which feel like a wave of heat that starts in your chest and face and then moves through your body
Have night sweats, which are hot flashes that happen when you are asleep
Have new headaches or trouble seeing
Notice milky fluid coming out of your breasts
Are under lots of stress
Have recently lost weight
Are exercising more than you used to
Have changed how much you eat or what kinds of foods you eat
Are taking any medicines, herbs, or vitamins
Are there tests I should have? — Your doctor or nurse will decide which tests you should have based on your age, other symptoms, and individual situation.
Here are the most common tests doctors use to find the cause of absent or irregular periods:
Pregnancy test – Pregnancy is a common cause of missed periods. Your doctor will want to find out if you are pregnant before doing any other tests.
Blood tests – These measure hormones that affect the reproductive system.
Pelvic ultrasound – This test uses sound waves to make a picture of your uterus, cervix, and vagina (figure 1). The picture can show if there is something wrong with these organs.
MRI – This test uses a large magnet to make detailed pictures of the brain. It can show if there is a problem in the part of the brain that controls the body's hormones.
How are absent and irregular periods treated? — That depends on what is causing your missed periods, and on whether you want to get pregnant. Possible treatments include:
Birth control pills to make periods regular
Losing weight if you are overweight
Medicines to help you get pregnant if you are having trouble getting pregnant on your own
Changing the way you eat and exercise, such as:
•Eating more calories
•Gaining weight if you weigh too little
•Easing up on exercise, if you exercise a lot
•Reducing stress
Hormones to treat hot flashes (if you are going through early menopause)
Medicines to lower prolactin levels (if your pituitary gland is making too much prolactin)
Can absent and irregular periods be prevented? — You can reduce your chances of missing periods by eating well and staying at a healthy weight. Being too thin or too heavy can cause irregular periods.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15427 Version 8.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.