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Oligomenorrhea: Symptoms and Pregnancy Effects

What is Oligomenorrhea?

Oligomenorrhea is categorized as light or infrequent menstrual periods, also known as anovulatory cycles, in women of childbearing age. Some fluctuations in menstruation are normal, but women who often go more than 35 days without a period may be diagnosed with the condition.

Because the menstrual cycle also affects ovulation, most women who experience Oligomenorrhea also experience fertility issues and may have trouble conceiving naturally.

Regular periods usually happen every 21 to 35 days. An Oligomenorrhea diagnosis is usually given if you go 90 days without one or have nine or fewer menstrual cycles per year.

Some doctors reserve the diagnosis for women who at one time experienced regularity in their cycle and then experience these kind of inconsistencies. Generally, women with Oligomenorrhea get just four to nine periods per year.

By definition, Oligomenorrhea is not diagnosable unless regular menstrual cycles have previously been established. In America by the age of 16, 97.5% of women have started regular menstrual cycles.

The absence of periods all together—whether they never start or stop completely—is called Amenorrhea. If periods stop for six months or more the Oligomenorrhea diagnosis is likely to be changed to Amenorrhea.

Most women experience irregular periods at the beginning and end of their reproductive lives. This is not categorized as Oligomenorrhea.

It occurs because of imbalanced coordination between the hypothalamus, ovaries and pituitary gland. Some women naturally menstruate only every other month and ovulate regularly each time.

This is not considered Oligomenorrhea. Rather, inconsistent cycles mark the condition.

How does Oligomenorrhea affect fertility?

Irregular menstrual periods are a sign of anovulation, irregular or abnormal ovulation. If you do not ovulate, you cannot conceive.

Because of this, virtually all cases of Oligomenorrhea affect fertility. Depending on the root cause and how irregular our periods are affects how much having Oligomenorrhea influences fertility.

Some women with Oligomenorrhea are able to conceive naturally, but it is often more difficult since they do not have as many opportunities to conceive.

Symptoms of Oligomenorrhea

Oligomenorrhea symptoms include:

  • Experience menstrual periods more than 35 days apart
  • Irregular menstrual periods and an unpredictable flow
  • Trouble conceiving

Causes of Oligomenorrhea

If you suffer from polycystic ovarian syndrome (PCOS), you are likely to experience Oligomenorrhea. In women with PCOS, small cysts form on the ovaries.

This can cause a range of changes to the regular menstrual cycle from Oligomenorrhea to Amenorrhea to very heavy menstrual bleeding and frequent periods. Roughly 6% of women in childbearing age experience PCOS. The condition is related to a surplus production of androgens (male hormones).

For women with PCOS, the likely cause of Oligomenorrhea is irregular levels of male and female hormones. Male hormones are present in small amounts in all women.

In women with PCOS, there is an overproduction of androgens, which is theorized as the root cause of PCOS. However, in the last couple of decades, some research has suggested that PCOS is caused by other abnormalities in the ovaries, including fundamental differences in the development of follicles.

There are many other physical and emotional stressors that can lead to Oligomenorrhea, including: chronic illness, estrogen-secreting tumors, poor nutrition, emotional stress, eating disorders such as anorexia nervosa or bulimia, performance-enhancing steroid drugs and excessive exercise.

Professional athletes, especially ice skaters, ballet dancers and gymnasts are at a high risk for Oligomenorrhea as their lifestyle calls for the combination of many of these stressors, like strict diet and heavy exercise. It is so common in fact, that Oligomenorrhea has been labeled as part of the “female athlete triad” of disorders, which also includes eating disorders and osteoporosis.

Since the 1990s awareness has grown about the risk and, though it has not been mitigated, the medical community has taken a larger stake in prevention. Oligomenorrhea usually occurs in athletes when body fat percentage drops too low.

When women in their adolescence experience Oligomenorrhea the ovaries, hypothalamus and pituitary glad being out of sync usually cause it. The hypothalamus is the part of brain that regulates many basic bodily functions.

Through hormone secretion, it regulates the pituitary gland. The pituitary gland secretes it’s own hormones, which regulate reproductive processes, like that in the ovaries. If synchronization is off between any of these reactions, it can lead to irregular menstruation.

Women with a history of endometrial cancer or endometrial hyperplasia are also at high risk for Oligomenorrhea.

Diagnosis of Oligomenorrhea

Conversation

The diagnosis of Oligomenorrhea begins with you. If you are experiencing irregular periods, tell your doctor.

Oligomenorrhea is not a condition that will come up on a test at your yearly check up. The doctor will ask questions and chart your history to look for patterns. If you have an opportunity to record your menstrual activity (frequency, time, length, flow), do so, as any information will help.

Exam

The next step is a physical exam to check things like weight, signs of normal reproductive development and regular vital signs. The doctor will also physically examine the thyroid gland to see if it may be swollen. A pelvic examine is also likely to be performed.

Lab test

From there, your doctor will perform a Pap test to check for specific causes of Oligomenorrhea that may be present. He or she may also do a test to check thyroid hormone levels or monitor estrogen levels.

Imaging

In some instances, your doctor may order an ultrasound to check for anatomical abnormalities in the pelvis, an x-ray to rule out bone fractures or an MRI to check for potential tumors affecting the pituitary glad or hypothalamus.

Treatment Options for Oligomenorrhea

The cause of Oligomenorrhea determines the treatment plan. Many women with Oligomenorrhea are treated effectively with birth control pills, which help regulate hormones and the menstrual cycle.

For women, such as athletes, experiencing Oligomenorrhea because of lifestyle and stress, eliminating those stressors can cure Oligomenorrhea completely. Addressing these treatable problems may benefit from mental health support to help change habits.

Women with Oligomenorrhea caused by PCOS are treated with hormones. Your doctor can identify specifically which hormones are out of balance and prescribe what’s needed to even them out.

Natural Therapies for Oligomenorrhea

If you want to know how to get regular periods naturally, you do have options. If a hormone imbalance is identified, tri-estrogen and natural progesterone are considered more “natural” treatments. Some women have also found help through acupuncture, mediation, herbs and diet changes.

While these approaches work best for women experiencing Oligomenorrhea due to external forces, they can be helpful for women with internal imbalances as well.

The prognosis of Oligomenorrhea

With the right treatment plan, many women are successfully treated for Oligomenorrhea and reach a place of more frequent and regular periods and ovulation. Most women find success treating their Oligomenorrhea through hormone therapy.

Again, it very much depends on the origin of the Oligomenorrhea, but there are many therapies available to try to solve the problem.

Is it possible to get pregnant with Oligomenorrhea?

It is possible to get pregnant with Oligomenorrhea. Some couples conceive naturally, but many need the help of infertility treatments to conceive.

Figuring out how to conceive with irregular periods is a common fertility issue. Many times, fertility drugs alone will do the trick, while other instances may call for utilizing fertility treatments like artificial insemination or IVF.

Oligomenorrhea itself does not cause pregnancy complications, but underlying causes of your irregular menstruation can be. It’s important to inform your doctor of irregular patterns, even if you’ve conceived without treatment.

How to Improve Your Chances Of Getting Pregnant with Oligomenorrhea

Figuring out how to conceive with irregular periods is a common fertility issue. Hormones or fertility drugs are most commonly used to increase your chance of getting pregnant with Oligomenorrhea.

Both approaches attempt to reengage a normal menstrual cycle so ovulation occurs normally and you are able to conceive. If these treatments do not work, couples may choose to move on to other fertility treatments, like IUI and IVF to increase their chances of conceiving.

When to call your doctor about menstrual disorders

Menstrual disorders are not likely to come up during a routine doctors visit. You know your body best and should consult your doctor if you experience menstrual irregularities or abnormal bleeding patterns, especially if menstrual periods are spaced more than 35 days apart.

Experiencing one or two off cycles does not usually indicate Oligomenorrhea, but if inconsistencies start to become the norm, it’s time to talk with your doctor about medical treatment, even if you are not trying to conceive at that time as it can be a warning sign of future infertility problems.

Additionally, if you are experiencing irregular periods and pregnancy signs, you may be pregnant and should consult your doctor as many women’s periods to not stop completely in the early stages of pregnancy.

Prevention of Oligomenorrhea

PCOS is not preventable, but Oligomenorrhea caused by low body fat is preventable and often reversible. Reasonable exercise schedules and adequate nutrition help keep body fat in check to prevent Oligomenorrhea.