Menstrual Irregularities

Menstrual irregularities are problems with a girl’s normal monthly period. For example, girls may miss periods, have them too frequently, have painful periods, or have excessively heavy flow.

Menstrual irregularities can sometimes be a sign of an underlying health issue. 

Patients can be seen by Texas Children's experts in Pediatric and Adolescent Gynecology.

Causes & Risk Factors

Possible causes include:

  • Pregnancy
  • Eating disorders
  • Extreme weight loss
  • Excessive exercise
  • Polycystic ovary syndrome (PCOS) – a common hormonal disorder that may cause irregular periods
  • Premature ovarian insufficiency (POI) – a common condition where the ovaries stop functioning normally; may cause periods to stop or occur irregularly
  • Endometriosis – condition in which uterine tissue grows elsewhere in the body; may cause heavy, painful periods
  • Pelvic inflammatory disease (PID) – infection of the reproductive organs; may cause irregular periods
  • Uterine fibroids – noncancerous growths of the uterus; may cause painful periods, heavy bleeding, and bleeding in between periods

Symptoms & Types

 Menstrual irregularities include:

  • Periods that are too far apart – instead of once a month 
  • Periods that are too close together – occurring every two or three weeks
  • Period doesn’t start by age 16 (amenorrhea)
  • Periods stop occurring (amenorrhea) – for at least 3 months and the woman is not pregnant
  • Periods that don’t come regularly (oligomenorrhea) – occurring infrequently
  • Heavy periods, or prolonged bleeding
  • Painful periods (dysmenorrhea) – severe menstrual cramps

Fever and illness after using tampons (toxic shock syndrome)

Diagnosis & Tests

Diagnosis starts with a thorough medical history, including a detailed discussion of a girl’s menstrual periods, what’s normal for her, and what irregularities are occurring.

A physical exam will also be conducted and when necessary, a pelvic exam.

In cases where a girl is sexually active, a pregnancy test and screening for infections may also be performed.

Treatment & Care

Treatment depends on the individual, her symptoms, and any underlying health issues causing the menstrual irregularity.  

Treatment strategies may include: 

  • Pain medication
  • Hormone therapy or birth control pills to help regulate the menstrual cycle
  • Regular pelvic exams – to ensure underlying problems are treated as soon as possible
  • Surgery, in rare cases