I’m 27 years old and have never really had any serious complications with my menstrual cycle. However, about three months ago, it became unusual. My normal period goes for about three  days tops. It then went on for almost a week but it was a very light flow.

Then it came back again, about three weeks later, heavier than ever. I have some pain sometimes but nothing too severe. Last month it went back to normal but I’m worried it will happen again and I don’t know why. Is this normal or is there something wrong with me? Please help.

Anita, Kiyovu

Dear Anita,

If you have been having normal periods before and now the cycle is irregular it is definitely something abnormal. As you are having a recent onset of frequent menses but with a low and then heavy flow, it indicates hormonal imbalance. The most common cause for this is stress.

Physical and or mental stress can lead to irregular menstrual cycles with an altered flow pattern. This may be transient for one or two cycles. Once the lady is relaxed, it becomes normal. For the same reason, women who indulge in heavy sports or physical work develop irregular menstrual periods.

Sudden weight gain or weight loss due to eating or psychological disorders also disrupts normal menstrual cycles. Taking caffeine in excess also tends to disturb the normal menstrual pattern by disrupting the normal hormonal cycle. Regular intake of alcohol and or smoking also has the same effect.

Since menses occur due to fixed hormonal changes in the body, hormonal disorders like hypo or hyperthyroidism can lead to a change in the menstrual flow pattern as well as the number of days. Change in type of contraceptive pills or injection can also lead to transient menstrual abnormality.

 Use of intra uterine device for contraception can also lead to altered menstrual flow. Polycystic ovarian syndrome is an abnormal condition of the ovaries wherein the graffian follicles of the ovaries continue to grow but fail to release eggs, i.e. ovulation does not occur. This affects the menstrual cycle as well.

There may be associated insulin resistance and new onset of diabetes mellitus as well. Some women tend to develop hair over the chin due to this ovarian disorder.  

Abnormalities in the uterus like fibroids or endometriosis are also responsible for irregular cycles.  If one has resumed menses after delivering a child, the periods can be irregular for some days. 

At times anti clotting drugs like warfarin or aspirin can induce heavy flow and can rarely alter dates of a menstrual cycle.

You can wait for your next menstrual period and watch the date, days and pattern of the flow to see if it is still abnormal. If under stress, try to be relaxed completely. Yoga and meditation can help you to relax completely. If involved in active athletic activities, maybe you can slow down for now.  Avoid coffee, alcohol and or smoking, if you indulge in taking anyone or more of these substances. Similarly if you have lost or gained weight recently try to correct it gradually.

If the abnormality continues in spite of these efforts, the best option would be to consult a gynecologist to evaluate the precise cause for altered menstrual cycles and take treatment for the same.

Dr Rachna Pande is a Specialist in Internal Medicine at Ruhengeri Hospital.