Oligomenorrhea or scanty menses is defined as when you do not get your period for 35 days or more or when you have only 4 to 9 periods in a year.
The average menstrual cycle is 28 days, and anything from 25 to 35 days is considered normal. So do not panic if you miss a single period (of course in absence of pregnancy; birth control or menopause) in a year; but if you regularly go 35 days or more between periods; you should visit your gynecologist.
Oligomenorrhea occurs in about 13 to 14 % of the general population. This number increases to 20% when women have existing fertility problems.
Causes of Oligomenorrhea
Oligomenorrhea in itself not a disease; but it may be the result of some medicines or underlying health problems like:
- PCOS or polycystic ovarian syndrome: PCOS causes imbalance in female hormone levels due to multiple fluid filled cysts in the ovaries; and production of abnormally high amount of male hormones called androgens. This is the most important cause of oligomenorrhea.
- Type 1 diabetes
- Use of hormonal contraceptives
- Intense physical activities in younger women.
- Certain medications like anti epileptics and antipsychotics
- Hyperthyroidism: In this condition; your body produces too much amount of thyroid hormones which enter the circulatory system and affect your menstrual cycle.
- Pelvic inflammatory disease: In this condition; like tuberculosis; the inner uterine lining or endometrium may get infected leading to oligomenorrhea.
- Asherman’s syndrome: In this condition; there is presence of scar tissue or adhesions inside the uterus which prevents proper development of the inner uterine lining and thus causes oligomenorrhea.
- Primary ovarian syndrome: It is also known as primary ovarian failure or premature menopause. Here the ovaries may function less than normal circumstances; so they may not produce adequate amount of hormones. And cause oligomenorrhea.
- Prolactinoma: It is a noncancerous tumor in your pituitary gland and is responsible for production of too much prolactin. This can lead to oligomenorrhea.
- Eating disorders like anorexia and bulimia
- Endocrine disorders like Cushing s syndrome and congenital adrenal hyperplasia
- Tumors in the ovaries or adrenal glands which release male hormones.
Diagnosis of Oligomenorrhea
Your gynaecologist will diagnose oligomenorrhea based on:
- Physical examination to check for any lumps; tender areas or extra body hair
- Vaginal examination: by this examination your gynaecologist will check you for any infection; inflammation; scar tissues or growths.
- Blood tests to check your sugar levels; protein levels and hormones like FSH; LH; Prolactin; TSH ; testosterone and HbA1C.
- Ultrasound examination of the abdomen and pelvis.
- Additional tests CT scan or MRI may be done.
Treatment of Oligomenorrhea
The treatment of oligomenorrhea may be done to treat the underlying cause.
In most of the cases; dietary modifications; lifestyle changes and weight reduction help.
Complicatons Due to Oligomenorrhea
As mentioned before; oligomenorrhea itself is not a problem but it is the problem born by other conditions which if not controlled can lead to various health problems like obesity; osteoporosis; cardiovascular diseases; infertility or endometrial thickening .
So to keep your reproductive health in good shape; please speak to your doctor if you have any concerns about your monthly periods.