Menstrual irregularities can be caused by a variety of conditions, including pregnancy, hormonal imbalances, infections, malignancies, diseases, trauma, and certain medications.1,2,3,4,5,6
Common causes of anovulatory bleeding (absent, infrequent periods, and irregular periods) include2:
- Adolescence
- Uncontrolled diabetes
- Eating disorders
- Hyperthyroidism or hypothyroidism
- Hyperprolactinemia (an abnormally high concentration in the blood of prolactin, a protein hormone)
- Medications, such as antiepileptics or antipsychotics
- Perimenopause
- Polycystic ovary syndrome (PCOS)
- Pregnancy
Common causes of ovulatory bleeding (heavy or prolonged menstrual bleeding) include2:
- Structural problems, such as uterine fibroids or polyps
- Bleeding disorders, such as leukemia, platelet disorders, the various factor deficiencies, or von Willebrand disease
- Hypothyroidism
- Advanced liver disease
Common causes of dysmenorrhea (menstrual pain) include6:
- Heavy menstrual flow
- Smoking
- Depression
- Never having given birth
- Endometriosis
- Chronic uterine infection
Additional causes of menstrual irregularity include1:
- Endometriosis
- Endocrine gland-related causes
- Acquired conditions
- Stress-related hypothalamic dysfunction
- Medications
- Exercise-induced amenorrhea
- Eating disorders (both anorexia and bulimia)
- Tumors
- Ovarian
- Adrenal
- Prolactinomas (a noncancerous pituitary tumor that produces prolactin)
- American College of Obstetricians and Gynecologists (ACOG) Committee on Adolescent Health Care. (2006). ACOG Committee Opinion No. 349. Menstruation in girls and adolescents: Using the menstrual cycle as a vital sign. Obstetrics & Gynecology, 108, 1323-1328. [top]
- Sweet, M. G., Schmidt-Dalton, T. A., Weiss, P. M., & Madsen, K. P. (2012). Evaluation and management of abnormal uterine bleeding in premenopausal women. American Family Physician, 85, 35-43. [top]
- Master-Hunter, T., & Heiman, D. L. (2006). Amenorrhea: Evaluation and treatment. American Family Physician, 73, 1374-1382. [top]
- Apgar, B. S., Kaufman, A. H., George-Nwogu, U., & Kittendorf, A. (2007). Treatment of menorrhagia. American Family Physician, 75, 1813-1819. [top]
- Practice Committee of the American Society for Reproductive Medicine. (2008). Current evaluation of amenorrhea [Review] Fertility and Sterility, 90, S219-225. [top]
- French, L. (2005). Dysmenorrhea. American Family Physician, 71, 285-291. [top]