Irregular periods

It's called a monthly cycle, and it more or less is: most women average 11 to 13 periods a year. If that's your norm, any change means something has shifted.

Here are some of the common causes of irregular periods:

• If there is a sudden halt to your periods, the most common cause is pregnancy.
• If the interval between periods has lengthened you could be headed for menopause. Fluctuating levels of hormones deriving from the ovaries and pituitary gland (hormone-controlling gland in the brain) go hand in hand with a decreased frequency of ovulation. The time span leading up to menopause is a gradual process of the ovaries going into retirement. The irregularity may last for two or three years before menstruation finally ceases. When no bleeding has occurred for one year, the menopausal transition is said to have occurred.

Bleeding after this time can be a sign of a serious underlying problem and should be seen to as soon as possible.

Other causes

If those two common causes have been ruled out, then the change may be due to:

• Excessive weight loss or gain. While a too-low body weight is a common cause of missed or irregular periods, obesity can also cause menstrual problems.
• Eating disorders, such as anorexia or bulimia.
• Increased exercise.
• Emotional stress.
• Illness.
• Travel.
• Contraception methods may cause less frequent, more frequent, or skipped periods or no periods at all.
• Drug abuse.
• Problems with the pelvic organs such as imperforate hymen, polycystic ovary syndrome or Asherman's syndrome.
• Breast-feeding. Many women do not resume regular periods until they have completed breast-feeding.

Things to remember when you see your doctor

When you see your gynae or GP, it will help them if you have the following facts to hand:

• Your last menstrual period?
• What day did it start? Was it normal?
• Do you have regular cycles, such as a period every 21 to 45 days?
• How old were you when your periods began?
• Are you sexually active?
• What type of birth control are you using? How long have you been using it?
• Have you missed any birth control pills or failed to have your hormonal injection according to schedule?
• Have you been under increased physical or emotional stress?
• Have you recently changed your diet or exercise habits?
• Have you recently gained or lost weight?
• What prescription and non-prescription medicines are you taking? Are you using illegal drugs?
• Do you have any health risks?

(Updated by Robyn von Geusau, Health24, February 2011)