Robert MacDermott - Consultant Gynaecologist
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  KIMS Hospital
  Kent, ME14 5FT
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Irregular periods

The term "irregular" means different things to different people. It may mean:

 Frequent Periods

Frequent periods can be very inconvenient. The greater the number of bleeding days per month, the more likely it is to have a significant cause. It is wise to seek medical advice.

 Infrequent periods

Infrequent periods have a variety of causes. They are common in the few years leading up to the menopause and can be safely ignored unless the bleeding is heavy and prolonged. In younger women the causes include Polycystic Ovary Syndrome (PCOS), hyperprolactinaemia, thyroid disease, weight loss and hormonal treatment including the Pill and mini-pill. Younger women should seek medical advice if they have infrequent periods.

 Prolonged periods

Prolonged periods, especially if heavy can lead to anaemia. A serious cause is unlikely if the pattern is regular and there are more than twice as many non-bleeding days as bleeding days. Fibroids are a common cause of prolonged bleeding. it is wise to seek medical advice if your periods are prolonged.

 Bleeding in between periods (Intermenstrual bleeding)

Bleeding in between periods (Intermenstrual bleeding) is a common symptom that occasionally is due to a serious condition. The key to recognising whether the cause could be serious (eg cancer or infection) is to work out whether there is a pattern to the bleeding. It is rare for a serious disease to result in a regular bleeding pattern. eg. a 4 month history of spotting at the same time of the cycle is very likely to have a simple hormonal cause BUT a 4 month history of spotting at irregular intervals throughout the cycle needs urgent investigation.

Intermenstrual bleeding is common in women who are using hormonal contraception, especially in the first few months of treatment. Abnormal bleeding which starts after this warrants medical attention.

You should bear in mind that certain conditions are more common at certain ages. Cervical cancer is incredibly rare below the age of 25 and very rare below the age of 30. However, Chlamydia infection often causes intermenstrual bleeding and is most common in women under 25 years. Cancer of the lining of the womb is very rare below the age of 40, with the great majority of cases occurring after the age of 50. These factors influence how a doctor will investigate a woman.

 Bleeding after sexual intercourse (postcoital bleeding)

Bleeding after sexual intercourse (postcoital bleeding) is recognised by doctors as a possible sign of cervical cancer. However, the vast majority of women with postcoital bleeding do not have cancer. Common causes include cervical polyps, cervical erosions (known by doctors as ectropions)and cervical infections eg. chlamydia. Often, no cause can be found. In postmenopausal women it may be due to a lack of oestrogen resulting in a thinning of the vaginal skin.

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