Menstrual Conditions/Irregularities- Irregular Menstruation

Irregular menstruation or period is defined as condition in which a woman is experience abnormal variation of length of the menstrual cycle. While the normal menstrual cycle is 28-35 days, women who are experience with irregular menstrual cycle can have a length variation between 8 and 20 days or shorter than 21 days, or longer than 36 days

Symptoms and signs
1. Menstrual bleeding
Menstrual bleeding for women with irregular menstruation is last more than 7 days.

2. Length of period
A length variation of one period to the next is between 8 and 20 days or shorter than 21 days, or longer than 36 days.

3. Heavy bleeding
Heavy bleeding that soaks menstrual pad or tampon every two to three hours is a sgin of irregular menstruation.

4. Amenorrhea
If a woman is experience with absence of period for more 90 days may be a sign of irregular menstruation.

5. Heavy bleeding with Blood clot
In answering the question of irregular period, thick blood, light flow, and clotting, Dr. Dr Rajesh Ramuka indicated that Hello, you need not to worry about your period because passing clot during menses is totally normal as during menses your body release anticoagulant to keep blood thin and prevent it from clotting,but during heavy period blood is released rapidly but anticoagulant do not get enough time to do his work so clot is formed.If you are getting clots of very large size on regular basis then consult your gynecologist.

6. Infertility
Women who are experience irregular menstruation are st higher risk of infertility. According to the article of "Irregular Periods and Getting Pregnant" posted at WebMD, Reviewed by Mikio A. Nihira, MD. the author stated that irregular or abnormal ovulation and menstruation accounts for 30% to 40% of all cases of infertility.
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Causes and risk factors
1. Age
As a woman approaches the age of 30, hormone production begins to change to the lesser stage. Women in the peri menopause stage can experience more irregular period than the younger age women as the result of diminishing of sex hormones, including estrogen and progesterone.

2. Reproductive diseases
Reproductive diseases such as fibroids, uterine bleeding and polyps can cause abnormal bleeding between period or heavy bleeding in the period.

3. Metrorrhagia
Metrorrhagia is defined as a condition of irregular period between expecting period.

4. Stop Using of birth control pill
Women who stop using of the birth control pill may experience irregular menstruation as a result of the women reproductive organs require time to adjust to the withdraw of the pill.

5. Birth control pill

Birth control can alter the length, blood volume, that can lead to irregular menstruation as a result of hormonal change.

6. Intensive exercise

In most cases, women who are extremely active in sports activities, are experience absence of period but in some women, it is the irregular menstruation instead.

7. Stress
Stress can cause hormonal change and prolonged period of stress can cause hormonal change large enough to affect the menstrual cycle normality.

8. Diet
Unhealthy diet such as typical American diet with high in saturated and trans fat with less fruit and vegetable is at higher risk of irregular menstruation of a result of hormonal change.

9. Medical condition

Certain medical condition such as disorders of the thyroid gland can cause menstrual irregularities if the levels of thyroid hormone in the blood become too low or too high.

10. Eating disorder
Eating disorder that can affect your monthly cycle as a result of irregular menstruation. According to the article of "Eating disorders may disrupt menstruation" By Anne Harding, posted in Reuters, the author wrote that any type of eating disorder can boost a woman's likelihood of having irregular menstrual periods, a new study confirms in a survey of 1,705 women participating in a genetic study who met strict diagnostic criteria for eating disorders, Bulik and her team found menstrual irregularities including absence of periods, skipping periods, and very light periods among women with every subtype of eating disorder, including bulimia nervosa,

11. Delayed Sleep Phase Syndrome
According to a study of 13 females with delayed sleep phase syndrome and 13 healthy controls. The subjects responded to a questionnaire regarding their reproductive health, including irregularity of their cycle and premenstrual symptoms, either in the past or present by Kari Sveum, of Northwestern University in Chicago, Ill presented on Tuesday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS), researcher indicated that delayed sleep phase syndrome reported an irregular menstrual cycle compared to controls.

12. Nutrient deficiency
In an article of "Eating behaviors in female volleyball players - Nutrition and Women's Topics" posted in Nutrition Research Newsletter. FindArticles.com. 16 Aug, 2011., the author indicated that the results show that dietetics professionals must take a proactive role in educating female athletes about the potentially severe consequences of chronic energy restriction, nutrient deficiencies and menstrual dysfunction on physical performance and health, while emphasizing the importance of a balanced, nutrient-dense diet.

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Diagnosis
If you are experience some of the symptoms above. there are certain test that you doctor may order.
After taking the precise family history to rule out medication and diseases and a physical exam, including the pelvic exam to rule out the abnormality, including cervical polyp or fibroid, or a uterine infection, causes of irregular menstruation.
1. Complete blood count (CBC) test
The aims of the test is to rule out the irregular menstruation as a result of anemia.

2. Blood Clotting test
If you are experience heavy bleeding, blood test of coagulation is to rule out the bleeding problem

3. Pelvic ultrasound
The aims of the test is make sure and rule out the abnormalities of the uterus, ovaries and the fallopian tubes causes of irregular menstruation.

4. Thyroid testThe aim of the test is to rule out the abnormal levels (too high or too low) of thyroid hormone cause of irregular menstruation.

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Prevention
A. How to prevent in common sense approaches
1. Reduce stress by meditation or yoga
Meditation and yoga can help to keep breathing slow and controlled and to relax and energized the body, thus reducing the stress.

2. Avoid intensive exercise

Intensive exercise can reduce estrogen levels, which can lead irregular menstrual cycle including irregular period

3. Nutrient deficiency
unhealthy diet can cause deficiency of vitamins and minerals, including vitamin B complex and magnesium , leading to irregular menstruation.

4. Weight loss

Weight loss too quickly increases the risk of hormonal imbalance that can lead to irregular menstruation.

5. Moderate drinking
According to the answer to the question of Does alcohol affect menstruation?, Chosen by AskerAppolnia_76 stated that YES it does... in a couple of different ways.First, it inhibits the secretion of the ADH, or anti-diuretic hormone from the pituitary gland in the brain... that's why we pee so much when we drink. You are essentially getting dehydrated, so the blood thickens and your menstrual flow will slow down until you re-hydrate yourself. Second, when you drink hard core, like lots of hard liquor or go on a bender for a few days, you can have extra periods or have skipped or late periods too. the reason for this is it messes up your metabolism and your hormones.

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B. Diet
1. Soy Products
Soy products contain high amount of phytochemicals, that can help to balance the body hormones, thus reducing the risk of irregular menstruation

2. Fruits and vegetables
Fruits and vegetables contain high amounts of vitamins, minerals, dietary fiber and plenty of antioxidants, that can provide the necessary nutrient to the body and reduce the risk of nutrient deficiency cause of irregular menstruation.

3. Flaxseed
Flaxseed not only contains high amount of essential fatty acids which are necessary for heart and reproductive health but also is an extraordinary source of the phytoestrogen lignans, containing 75 to 800 times as much as other plant sources, helped to reduce the risk of the diseases.

4. Beans
Due to high amount of fiber, bean can help to slow the absorption of glucose in the bloodstream, thus reducing the risk of high blood sugar for some menopause with disease of diabetes.Beans are also high sources of vitamin and mineral,such as calcium, folic acid and vitamin B-6. And they also contain some sources of phytoestrogen.

6. for more information of healthy food visit 100+ Healthy Foods Classification

C. Nutritional supplements

1. Iron
Iron is essential for women suffering from menorrhagia. Since excessive bleeding causes the loss of iron causing iron deficiency, without enough iron our body cannot reproduce red blood cells to replace those lost in bleeding resulting in symptoms of paller, weakness, fatigue as well as increasing the risk of inflammation.

2. Vitamin B complex
Vitamin B complex is a liver tonic vitamin. It helps the liver to convert the bad estrogen, xanooestrogen into weaker and less dangerous forms and converts omega 6 oils into a form that can be used by the body to produce the good type prostaglandins instead of dinoprostone resulting in reduced bleeding during menstruation.

3. Cod liver oil
Cod liver oil contains high amounts of omega 3 fatty acids that control heavy bleeding during periods. Since red meat and dairy products contain arachidonic acid without balancing intake of omega 3 fatty acid, this causes the over production of dinoprostone leading to increased blood flow, and reducing blood-clotting ability.

4. Zinc
Besides having an important role in treating enlarged prostate in men's health, this mineral is vital for the healthy functioning of the reproductive system in women as well as maintaining hormone balancing.

5. Flavonoid
Flavonoid is a powerful antioxidant activity. It helps to protect small blood vessels from damage resulting in protecting against the blood loss of menorrhagia during menstruation.

6.Vitamin A
Vitamin A is an antioxidant. It works together with iron and copper to help enhance the production of red blood cells. Vitamin A deficiency has been found in women with menorrhagia.

7. Vitamin C
Besides being an antioxidant that helps our body to fight against free radicals from building up and help the digestive system's metabolism to reduce menstrual pain, it also helps excessive blood flow during menstruation as a resulting of strengthening small blood vessels known as capillaries.

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Treatments
A. In conventional medicine
A.1. Hormone treatments
1. Contraceptive pill
a. Low-dose combination birth control pills which contains low-dose synthetic forms of the hormones estrogen and progesterone may be use to treat amenorrhea by controlling the menstrual cycle or bring the period back.
b. Risks and side effects
b.1. Growth of fibroids
Growth of fibroid is caused high level of estrogen and progesterone. The intake of the pill increase the level of both hormones resulting in increase the risk of growth of fibroid.
b.2. Recurrent of menstrual symptoms
Some women stop taking the pill may see all the menstrual symptoms coming back.
b3. Blood clots
Estrogen in the pill may cause blood clots in the small vessels in the leg and the lung.
b.4. Stroke and heart diseases
Study shows that women who have higher natural estrogen levels may have a higher risk of stroke and heart diseases.
b.5. Depression and mood swing
At the beginning, it may cause abnormal fluctuations in estrogen and progesterone elevate both physical and psychological stress, eventually resulting in both depression and mood swing
b.6. Bleeding and spotting
Bleeding and spotting is normal for the first six months for women who begin with any oral contraceptive combination pill treatment.
b.7. Lost interest in sex
Some women may experience lower sexual desire
b.8. Nutritional deficiency
Oral contraceptive pill causes vitamin and mineral imbalances or deficiencies.
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2. Progesterone only pill
Norethisterone a progestogen and has been used used treat premenstrual syndrome, painful periods, abnormal heavy bleeding, irregular periods. In a study of A comparative study of danazol and norethisterone in dysfunctional uterine bleeding presenting as menorrhagia M. Bonduelle, J.J. Walker and A.A. Caldert, researcher found that Since this study was undertaken, a report of
objective measurement of blood loss in small groups of patients9 casts further doubt on the
efficacy ofnorethisterone, although it confirms that of danazol. Since norethisterone is very widely used, a detailed assessment of its efficacy and safety in comparison to danazol is overdue. Should such a study confirm the findings discussed here then danazol could usefully be employed as first line therapy in the management of dysfunctional uterine bleeding presenting as menorrhagia.

B. Herbs
1. Black Cohosh
Black cohosh beside has been used as an emmenagogue to contracts the uterus and initiate menstruation, it also enhances hromone balancing.

2. Chaste tree berry
Chaste tree berry is considered as a queen herb in herbal medicine to regulate the women menstrual cycle by balancing the estrogen and progesterone produced by the ovaries throughout the menstrual cycle.

3. Raspberry leaf
Red Raspberry leaf, a pale-green leaf produced by the raspberry plant has been used in herbal medicine because of its rich content in vitamins, minerals, and tannins and as an aid in delivery. Herbalists suggested that red raspberry leaf enhances the lining of uterus and promotes female reproductive system, including decreasing profuse menstrual flow and treating irregular menstruation.

4. Cat's claw
Cat's claw is a woody vine found in the tropical jungles of South and Central America> The herb has been used traditionally to treat gastrointestinal ailments, Crohn's disease, gastric ulcers tumors, and women's hormone imbalances.

5. Turmeric
Turmeric is a rhizomatous herbaceous perennial plant of the ginger family and has been use as an antiseptic agent for cuts, burns and bruises as well as an aid digestion and liver function, relieve arthritis pain, and regulate menstruation, in traditional medicine.

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C. Traditional Chinese medicine
1. Angelica root
Chinese Angelica is a sturdy perennial plant that is native to China and Japan. It has been used for over 5000 years in traditional Chinese medicine in treating an overall tonic for the reproductive system as well as balancing hormones and it is also used to relieve the discomforts of premenstrual syndrome, dysmenorrhea, irregular menstruation and amenorrhagia. It is well known as female ginseng.

2. Radix Notoginseng
Also known as tian san qi or tien chi ginseng. It has been used in China for centuries in treating excessive bleeding in irregular menstruation. It is widely used in Asia for angina to help lower cholesterol and triglycerides, and to expand coronary arteries in order to promote blood circulation and prevent blood clots thereby helping to control excessive menstrual bleeding or menorrhagia. It also is a powerful antioxidant that helps to reduce inflammation thus reducing pain caused by menstruation disorders.

3. Licorice
Licorice has been used in traditional Chinese medicine to detoxify and to enhance or balance the effects of other herbs in herbal formula as well as promote estrogenic activity. In a study of "Estrogen-like activity of licorice root constituents: glabridin and glabrene, in vascular tissues in vitro and in vivo". by Somjen D, Knoll E, Vaya J, Stern N, Tamir S., researchers concluded that glb behaved differently than E2 or gla, but similarly to raloxifene, being a partial agonist/antagonist of E2. Glabridin, on the other hand, demonstrated only estrogenic activity. Therefore, we suggest the use of glb with or without E2 as a new agent for modulation of vascular injury and atherogenesis for the prevention of cardiovascular diseases in post-menopausal women.

4. Motherwort
Motherwort is a herbaceous perennial plant in the mint family, It has been used in trdiational Chinese medicine in tonifying the uterus and preventing the uterus against infection. Leonurine, a compound in the herb has an effect in promoting uterine contractions. As an emmenagogue, it enhance blood flow.

5. Skullcap
Skullcap is a genus of flowering plants in the mint family, Lamiaceae. It has been used in traditional Chinese medicine to tonify the heart, treat insomnia and enhance immune system. It is said that a infusion of the plant can be used to promote menstruation. According to the article Skullcap - Botanical and Common Names posted in Innvista, the author indicated that An infusion of the fresh aerial parts (if possible) is used to soothe nervous exhaustion, excitability, overanxiety, and premenstrual tension.

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