An Overview of Oligomenorrhea

What Is Oligomenorrhea?

Oligomenorrhea is a health issue characterized by irregular menstrual periods. This condition mostly happens in women during the childbearing age. It is normal to experience some variation in menstruation. However, when a woman who often goes more than 5 weeks without menstruating might be diagnosed with oligomenorrhea. It also refers to a condition in which women have no more than 9 menstrual periods in the entire year. Many cases of oligomenorrhea are harmless, but some of them would indicate a more severe underlying condition. [1]

Symptoms of Oligomenorrhea

Frequent irregularity of menstrual cycles or missing a period is normal. However, when this condition lasts longer than usual and affects your daily lives, it is significant to notice any changes. Typical symptoms of oligomenorrhea include a lighter period than usual, irregular menstrual cycles, having fewer than 9 periods in the whole year, or going longer than 5 weeks without a period. You might experience other signs of the period when the different bleeding occurs. These include bloating, cramps, and premenstrual syndrome. In some cases, you would experience no other signs. The blood would have a light pink, red, or dark brown color. You would notice mucus or clots in the underwear as well. [2]

Causes of Oligomenorrhea

In healthy individuals, hormonal changes are a sign of building up the lining of women’s uterus to prepare for a fertilized egg each month. When the lining is unnecessary, the tissue will slough off and pass into the vagina via the cervix. This is how a period happens. A normal menstrual cycle should be more or less 4 weeks. This cycle can be affected by some factors, such as side effects of hormonal birth control pills, heavy exercises, and eating disorders like bulimia and nervosa. The condition is also more common in perimenopausal women and adolescent girls because of fluctuating levels of the hormone. [3]

Perimenopause and Oligomenorrhea

When a young girl experiences the first menstrual cycle, it would take her a couple of years until periods start to have a persistent pattern. At first, irregular periods and bleeding, which is lighter or heavier than the latest month are not uncommon. As they grow, hormones often stabilize. These changes in menstrual cycles would also occur when people enter menopause. The hormonal variations happening to facilitate this process might result in periods, which come later or sooner than expected. They can also vary in heaviness and duration. [4]

Medication-Induced Oligomenorrhea

Some medications would have a significant effect on the menstrual cycle. These include Depo-Provera shots, birth control pills, inserted IUD, or using a ring or a patch. In certain women, periods would become heavier and more frequent. However, you would have the infrequent, light periods when oligomenorrhea occurs. Those who often change methods or take birth control irregularly would also experience unpredictable or abnormal bleeding. Symptoms tend to improve when you use a suitable medication consistently. Other drugs that would increase the risk of oligomenorrhea include antipsychotic or anti-anxiety drugs, epilepsy medications, as well as anticoagulants like aspirin. [5]

Other Risk Factors

Menstrual cycles can be changed when you are breastfeeding, giving birth, or getting pregnant. Some lifestyle changes would also increase the risk of oligomenorrhea, such as unexpected weight loss, excess stress, and going on vacation. Malnutrition would make the periods become irregular or even stop. The risk is especially high in those with eating disorders like bulimia or anorexia nervosa. In some cases, oligomenorrhea would be a sign of serious health conditions. These include diabetes, Prader-Willi syndrome, Graves’ disease, the use of anabolic steroid, obstructions of the vagina, cervix, or uterus, thyroid problems, hormone-secreting tumors, prolactinomas, hyperprolactinemia, polycystic ovarian syndrome, pelvic inflammatory disease, and primary ovarian insufficiency. [6]

Physical Exam

To diagnose oligomenorrhea, a doctor first needs to ask some questions concerning your health, menstrual health of your sisters or mother, and a history of cancer or health issues in the reproductive system. After that, you need to report noticed symptoms, along with any births or pregnancies you have had. A physical exam around the rectovaginal area is needed to check for any abnormalities. During this procedure, the doctor will cover their fingers with gloves and lubricates to feel inside the vagina and rectum. You would feel a bit embarrassed or uncomfortable, but the exam tends to be quick. [7]

Diagnostic Tests

If a physical exam cannot determine the exact cause of oligomenorrhea, then your doctor might need to do other tests to confirm. In most cases, less invasive procedures are required in the first steps until more comprehensive tests are needed in challenging cases. To start, you need to get a urine or blood sample, which can be used for testing many conditions that would trigger menstrual irregularities. These include inflammation, infections, nutritional deficiencies, STDs, and bleeding. You can also be tested for thyroid function and hormone levels. Another option is a pap smear to check for signs of cervical cancer. To examine the reproductive parts, certain imaging tests like MRIs, CT scans, or ultrasounds can help. [8]

Lifestyle Changes

After a diagnosis, the doctor will tell you the cause of oligomenorrhea. The right treatment option will depend on your overall health and the underlying health condition. Common options for many people might not be suitable for you. If symptoms occur due to certain lifestyle factors, then you might need to make some changes to prevent further issues. These include reducing levels of stress, working out regularly, and maintaining a healthy weight. Your condition would improve quicker after gaining weight, beginning a new schedule, or returning from a vacation. [9]

Hormone Therapy and Birth Control

If oligomenorrhea occurs due to hormonal changes, then some birth control medications would help manage the periods. They can even be used for those who have never had sex or are not sexually active. Common options include IUDs, rings, patches, and pills. Consult your doctor to choose the right one for your conditions. In some cases, you would need more than one option to alleviate symptoms. An alternative is hormone therapy. However, this treatment is not good in the long run. It can also have certain side effects. [10]

Treatments for Underlying Conditions

Antibiotics can be used for treating STIs or STDs that cause oligomenorrhea. During this time, it is advisable to abstain from sexual intercourse to prevent the bacteria from transmitting to your partner. Other treatments can be suggested to deal with underlying conditions. For instance, an endocrinologist will help you find a suitable option to treat a thyroid condition. When more severe issues occur, such as cancer, specialized surgery might be needed. Regardless of the causes, always consult your doctor and follow instructions. [11]

Outlook

Most cases of oligomenorrhea are often mild with abnormally light or infrequent periods. However, some cases would indicate a more severe health condition that requires medical attention. More research on the role of genetic factors and menstrual disorders is needed to give us the best answers. If you usually go without a period for more than 7 weeks, then it is better to visit your healthcare provider to seek medical advice. This is especially important when you are in a group with high risks. [12]

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