Absent or Irregular Periods (Ovulation Problems)

Menstrual cycle disorders can cause a woman’s periods to be absent or infrequent. Although some women do not mind missing their menstrual period, these changes should always be discussed with a doctor because they can signal underlying medical conditions and potentially have long-term health consequences. A woman who misses more than three menstrual periods (either consecutively or over the course of a year) should see a doctor. Amenorrhea — Amenorrhea refers to the absence of menstrual periods, and is classified as either:

  • Primary (when menstrual periods have not started by age 16)
  • Secondary (when menstrual periods are absent for more than three to six months in a woman who previously had periods) Oligomenorrhea — Oligomenorrhea is the medical term for infrequent menstrual periods (fewer than six to eight periods per year).

Causes of Irregular Periods

The brain (including the hypothalamus and pituitary gland), ovaries, and uterus normally follow a sequence of events once per month that helps to prepare the body for pregnancy. Two hormones, follicle stimulating hormone (FSH) and luteinizing hormone (LH), are made by the pituitary gland. Two other hormones, progesterone and estrogen, are made by the ovaries. Menstrual cycle disorders can result from conditions that affect the hypothalamus, pituitary gland, ovaries, uterus, cervix, or vagina. Primary amenorrhea- Some of the more common causes of primary amenorrhea include the following:

  • Conditions that are present at birth, but may not be noticed until puberty. These conditions include genetic or chromosomal abnormalities and abnormalities of the reproductive organs (eg, if the uterus is not present or developed abnormally).
  • All of the conditions that lead to secondary amenorrhea can also cause primary amenorrhea. Secondary amenorrhea — Pregnancy is the most common of secondary amenorrhea.

Other common causes include the following:

  • Ovarian conditions, such as polycystic ovary syndrome and ovarian failure (early menopause).
  • Hypothalamic amenorrhea. This occurs when the hypothalamus slows or stops releasing GnRH (gonadotropin releasing hormone), a hormone that influences when a woman has a menstrual period.
  • Prolactin-secreting pituitary tumors are another common cause of secondary amenorrhea. Oligomenorrhea — Many of the conditions that cause primary or secondary amenorrhea can also cause a woman to ovulate irregularly (oligomenorrhea). However, most women who develop infrequent periods have polycystic ovary syndrome .