Scanty, Irregular, Infrequent Periods and Intermenstrual Bleeding

Scanty, irregular, infrequent periods and bleeding in between periods are some of the common types of menstrual disorders that occur for which many women seek medical help. The menstrual cycle can vary greatly in women, ranging from 21 to 35 days normally with the average being a 28 day cycle. The menstrual flow and duration of menstruation also varies among women, or even in the same woman under different circumstances. A normal menstruation may last from 2 to 7 days, with an average blood loss of 25 to 80 mL.

What is Oligomenorrhea and Hypomenorrhea?

Broadly speaking, ‘scanty period‘ is a layman’s term used to describe infrequent or light menstrual bleeding. The duration of menstrual flow may also be less than normal and sometimes the flow may only amount to slight spotting.

In medical terms, oligomenorrhea is used to describe infrequent periods, occurring more than 35 days apart. The amount of blood flow is usually less and may be associated with anovulation.

The term hypomenorrhea is used to describe unusually light menstrual bleeding or spotting.

Causes

• It usually occurs in the extremes of reproductive life when there may not be regular ovulation – in adolescence, just after menarche, and at the time of menopause.
• Throughout the reproductive years, polycystic ovarian syndrome (PCOS) is a common cause of oligomenorrhea.
• Pregnancy.
• Pituitary-hypothalamic disorders.
• Hyperthyroidism – overactive thyroid gland.
• Excessive weight loss.
• Eating disorders.
• Stress.
• Intense physical exercise.
• Estrogen-secreting tumors usually produce oligomenorrhea prior to the development of other types of abnormal bleeding.
• Hypomenorrhea may be caused by Asherman’s syndrome where there is formation of adhesions within the uterus, typically developing after uterine surgery.
• Use of oral contraceptives may result in decreased menstrual flow.
• Cervical stenosis may be the cause of light flow.

Intermenstrual Bleeding

Also known as metrorrhagia, intermenstrual bleeding or bleeding in between periods may occur due to a number of causes.

Causes

• Ovulatory bleeding may follow a mid-cycle fall in estrogen production and occur as spotting.
• Cervical and uterine polyps.
• Uterine fibroids.
• Ectropion.
• Uterine cancer and cervical cancer.
• Cervicitis.
• Vaginitis.
• Pregnancy-related, such as miscarriage or ectopic pregnancy.
• Hormonal contraception.
• Intrauterine device (IUD).

Irregular Periods

Irregular periods are also known as menometrorrhagia. The bleeding may occur at irregular intervals and vary in amount as well as duration. Any condition that causes intermenstrual bleeding can eventually lead to menometrorrhagia.

Causes

Sudden onset of irregular bleeding episodes may indicate :

• Complications of pregnancy, such as a threatened abortion (miscarriage).
• Uterine and cervical cancer.

The other causes of irregular periods may include :

• Hormonal imbalance at the time of menarche and menopause. Within a few months of menarche the menstruation usually becomes regular. Irregular periods during menarche and just prior to menopause are usually not of much medical concern and do not require any treatment in most cases.
• In spite of being pregnant, some women continue to have irregular bleeding, especially during the first trimester of pregnancy.
• Stress.
• Illness.
• Eating disorders.
• Excessive weight gain or loss.
• Hormonal drugs, including oral contraceptives, if not taken in the correct dose.
• Breastfeeding.
• Uterine fibroids.
• PCOS.
• IUD.