Oligomenorrhea is a cycle disorder (menstrual disorder) with several possible causes. Addressing the causes usually has a positive effect on oligomenorrhea.
What is oligomenorrhea?
According to the definition of the WHO (World Health Organization), we talk about oligomenorrhea when the total female cycle is prolonged or when there is a period that is too short and weak. The opposite of this is menorrhagia (long and heavy menstruation). A distinction can be made, among other things, between so-called primary and secondary oligomenorrhea: Primary oligomenorrhea is present when a woman affected has had a menstrual period that is too infrequent or too short and weak since her first menstrual period (menarche). In secondary oligomenorrhea, menstruation after menarche was initially normal, and only over time did infrequent menstruation or menstruation that was too short and weak develop. A cycle prolongation in oligomenorrhea can be at least 35 days and at most 90 days. Oligomenorrhea often occurs at the onset of puberty or at the beginning of menopause.
Causes
Possible causes of oligomenorrhea are varied. If oligomenorrhea occurs in the first period after menarche or before menopause, it may be an expression of hormonal changes taking place in the female body. However, various diseases can also lead to oligomenorrhea. For example, there may be disorders that affect the function of the ovaries or hormonal disorders in which too much male hormones are produced. Thyroid dysfunction (both hypofunction and hyperfunction) or tumors such as uterine cancer can also lead to oligomenorrhea. In addition, oligomenorrhea can be psychologically favored (for example, by high stress) and can also be a consequence of anorexia. Last but not least, playing competitive sports can lead to the occurrence of oligomenorrhea in women.
Symptoms, complaints and signs
The main symptom of the condition is infrequent menstrual bleeding. The cycles lengthen in oligomenorrhea to a duration of 35 to 90 days. In rare cases, even longer periods are possible. Affected women usually had normal length cycles of about 24 to 30 days before the onset of oligomenorrhea. Normally, bleeding is weaker and shorter than before. However, they can also occur with the usual strength and duration. Rarely, there is very weak bleeding and spotting, but this can last up to two weeks. For hormonal reasons, other cycle disorders can occur in affected women. For example, they may experience intermenstrual bleeding or increased menstrual cramps. Depending on the underlying disease and cause of oligomenorrhea, other symptoms may be present. If ovarian cysts or polycystic ovarian syndrome are present at the same time, there may be severe weight gain and obesity. Rarely, there is increasing masculinization. Affected individuals notice increased body hair. There may also be beard growth on the face and simultaneous loss of head hair. Rarely, the clitoris enlarges and increased muscle mass is formed. If an increased prolactin level is the cause of oligomenorrhea, the breasts of the affected person secrete a milky fluid.
Diagnosis and course
The diagnosis of causes of oligomenorrhea usually begins with a patient consultation with the treating gynecologist; patients are often asked here about their medical history, which can often already give the doctor clues about possible causes of oligomenorrhea. This is usually followed by a gynecological examination in which the ovaries, uterus and vagina are palpated. In order to diagnose the causes of oligomenorrhea, these examination steps are often supplemented by an ultrasound examination. Blood tests can also be used to detect any hormonal disorders or other diseases that may have led to oligomenorrhea. In the course of oligomenorrhea, usually only the symptoms of infrequent or too short and weak menstrual periods appear. Depending on the cause of oligomenorrhea, in individual cases there may be, for example, obesity, fluid secretions from the breasts or strong body hair.
Complications
In this disease, the affected individuals suffer from various symptoms. However, the further course and treatment of this disease strongly depend on the underlying disease, so that no general course can be given in this case. As a rule, however, patients suffer from a very weak menstrual period, which, however, lasts for a long time. This is accompanied by cycle disturbances and severe mood swings. Depression or other mental illnesses can also occur as a result of the disease and have a negative effect on the quality of life and also on the relationship with one’s partner. Furthermore, those affected suffer from cysts on the ovaries and in many cases also from excessive hairiness. The hairiness can also lead to reduced self-esteem or inferiority complexes. In many cases, those affected feel uncomfortable and ashamed of the discomfort. The woman’s desire to have children may also not be fulfilled due to the condition. There are usually no complications during treatment. The symptoms can be alleviated with the help of hormones. In some cases, however, those affected are dependent on psychological therapy. Life expectancy, however, is not affected by the disease.
When should one go to the doctor?
Oligomenorrhea almost in every case indicates a hormonal problem or at least a change, which will not normalize on its own. That is why every woman, regardless of age, should see the doctor if menstrual periods last only a short time, are weak and occur less frequently than usual. A harmless form of oligomenorrhea occurs in young girls immediately after menarche, although not in every girl. While a few girls get their regular cycle right away, for others it takes one or two cycles before regularity sets in. However, if periods do not come as frequently as they should, then the gynecologist should be consulted. Normally, oligomenorrhea can also occur after pregnancy and childbirth, because even now the cycle must first normalize. Short-term oligomenorrhea also occurs after stopping hormonal contraception. These are all natural causes and not yet a reason to see a doctor. Sudden oligomenorrhea, on the other hand, should be cause for a checkup with a gynecologist, because if a woman previously had a normal cycle and it changes, there is a reason. Middle-aged women might be going through menopause, for example. However, oligomenorrhea can also indicate hormonal imbalance, endocrinological disorders or a physical disease that needs to be detected in time.
Treatment and therapy
Whether medical treatment of oligomenorrhea is necessary or useful depends mainly on the causes of oligomenorrhea:
If a too infrequent or too short and weak menstrual period is due to hormonal disorders and if an affected woman has a desire to have children, hormonal therapy methods can be used, for example. If an over- or underactive thyroid gland has led to oligomenorrhea, this dysfunction can be countered with drug treatment, among other things, to combat oligomenorrhea. Even if a tumor is present as the cause of oligomenorrhea, successful tumor treatment can lead to the oligomenorrhea also receding. Anorexia as a cause of oligomenorrhea is often treated with the help of combined treatment methods:
While nutritional rebuilding therapy is often carried out to help an affected woman achieve a normal weight, this therapy component is usually supplemented by individually oriented psychotherapy. With a successful course of therapy, the oligomenorrhea present may also subsequently decrease.
Outlook and prognosis
The prognosis for oligomenorrhea depends on the factors that caused the cycle disorder. If the short and weak menstrual period occurs during times of heavy physical or emotional stress, the menstrual cycle often finds its way back to its natural rhythm on its own after the stressful period of life ends. Learning relaxation techniques and a healthy lifestyle with a balanced diet and sufficient sleep can support this process.Oligomenorrhea occurring in early puberty does not usually require treatment either and turns into a normal menstrual cycle as soon as hormone production in the young woman’s body has settled down. If the short and weak menstrual period is due to a mental illness such as anorexia nervosa, longer-term psychotherapeutic care may be necessary to stabilize the patient’s body and mind. An organically caused oligomenorrhea can often be completely eliminated by effective treatment of the underlying disease. In the case of hyperthyroidism or hypothyroidism, medication is used, while ovarian dysfunction or tumors are usually treated surgically. If poor menstruation is caused by polycystic ovary syndrome (PCOS), hormone therapy can support the maturation of eggs and ovulation in women with an unfulfilled desire to have children. This treatment significantly increases the chance of pregnancy.
Prevention
Oligomenorrhea can be prevented first by identifying and treating possible causative diseases early. Hormonal factors that can lead to oligomenorrhea can be positively influenced by various behavioral measures: Oligomenorrhea due to hormonal factors, for example, can be prevented by measures such as stress reduction, adequate sleep, a healthy diet, abstaining from nicotine, and avoiding underweight and overweight.
Follow-up
In most cases, there are no special or direct measures of aftercare available to the person affected by oligomenorrhea, so the person affected by this condition should usually see a doctor at an early stage. In most cases there is no self-healing, so that a visit to a doctor is always necessary for the patient. The earlier a doctor is contacted, the better is usually the further course of the disease. In most cases, oligomenorrhea is treated by taking various medications. Here, it is always important to ensure that the medication is taken regularly and in the correct dosage in order to alleviate the symptoms permanently and sustainably. If there are any uncertainties, questions or side effects, a doctor should also be consulted first. Most of those affected also depend on the support of their own family or partner, which can also prevent depression or other psychological upsets. Oligomenorrhea does not reduce the life expectancy of the affected person.
This is what you can do yourself
If oligomenorrhea occurs during puberty or shortly before menopause as a result of the natural hormonal change, it is usually not perceived as a nuisance – treatment is therefore not necessary. If, as a result of the cycle disorder, a woman’s desire to have a child cannot be fulfilled, she should measure her basal body temperature for a certain period of time and keep a menstrual calendar: These records make it easier for the doctor to determine the cause. In addition to any medical treatment that may be necessary, some medicinal plants have proven effective in combating menstruation that is too short and weak: Monk’s pepper is particularly worthy of mention here, as it can balance hormonal imbalances and stabilize the menstrual cycle when taken over a longer period of time. In Far Eastern medicine, ginger and aloe vera are also used to stimulate menstruation. If oligomenorrhea is due to stress or great mental strain, regular relaxation exercises such as autogenic training or yoga can have a balancing effect. In the case of physical overstrain, for example due to excessive sporting activity, a reduction in the amount of training can help, and cycle irregularities caused by being underweight usually disappear once the normal weight has been reached. If an eating disorder is the cause, psychotherapeutic treatment should be sought. A healthy lifestyle with a balanced diet, a balanced ratio of activity and recreation, and largely abstaining from nicotine can also have a favorable influence on the menstrual cycle.