Attia, G. M., Alharbi, O. A., & Aljohani, R. M. (2023). The Impact of Irregular Menstruation on Health: A Review of the Literature. Cureus, 15(11), e49146. https://doi.org/10.7759/cureus.49146
Attia GM, Alharbi OA, Aljohani RM. The Impact of Irregular Menstruation on Health: A Review of the Literature. Cureus. 2023;15(11):e49146. doi:10.7759/cureus.49146
Attia, Ghalia M., et al. "The Impact of Irregular Menstruation on Health: A Review of the Literature." Cureus, vol. 15, no. 11, 2023, pp. e49146.
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Irregular cycles are linked to diabetes, heart disease and infertility
Irregular periods are linked to type 2 diabetes, heart disease and infertility, a 2023 review of studies from 2013 to 2023 reports. The reviewers also describe links with anemia, osteoporosis and depression.
Key Findings
Reported prevalence of irregular cycles varied widely by country: 14.3% in Korea, 29.7% in Saudi Arabia, 33.3% in Egypt, 35.7% in India and 64.2% in Nepal.
Women with long or extremely irregular cycles had a significantly higher risk of type 2 diabetes. One cross-sectional study linked irregular menstruation to high triglycerides, large waist circumference and low HDL cholesterol.
Women with a history of irregular cycles had a 28% higher risk of coronary heart disease than women with regular cycles.
Irregular periods were associated with more than twice the odds of infertility.
Menstrual irregularity seems to be its own risk factor for pregnancy-induced hypertensive disorders, which affect nearly 2-5% of pregnancies.
Interpretation
This literature review examined English-language articles from 2013 to 2023. The authors searched PubMed, Medline, Embase and the Cochrane Library for links between irregular cycles and other health problems. For the metabolic, heart and pregnancy risks, the authors point to polycystic ovary syndrome (PCOS) as a likely cause. An international panel has since renamed this condition polyendocrine metabolic ovarian syndrome (PMOS). The findings support larger studies on cycle regularity and these health risks.
RRM Context
ACOG has published a Committee Opinion on using the menstrual cycle as a vital sign. The review notes that doctors often cannot identify the reason for irregularity after history and examination alone. Restorative reproductive medicine reads an irregular cycle as information about ovulation and looks for the underlying cause. Cycle charting records length and bleeding day by day, giving the clinician data to work from.
Our editorial summary of this paper, not the article's abstract.
Abstract
Women are considered to have an irregular menstrual cycle if their cycle length is less than 21 days or more than 35 days, accompanied by less or very severe blood flow. The prevalence of menstrual cycle irregularities varies across countries. Irregular periods can occur due to changes in the body's levels of estrogen and progesterone hormones, which disrupt the normal pattern of the period. Menstrual irregularity has been found to be associated with various diseases and medical conditions, such as metabolic syndrome, coronary heart disease, type 2 diabetes mellitus, and rheumatoid arthritis. Anemia, osteoporosis, psychological problems, impaired quality of life, and infertility have also been recorded. Moreover, a significant correlation between irregular periods and the risk of developing pregnancy-related hypertensive disorders, as well as an increased risk of adverse obstetric and neonatal outcomes, has been proven. Therefore, irregular menstruation is considered an important health indicator among women. Physical, mental, social, psychological, and reproductive problems are often associated with menstrual irregularities. Thus, evaluating the factors associated with irregular menstruation is necessary to determine appropriate preventive and treatment strategies and to decrease the associated health problems. The aim of this review was to define normal and irregular menstruation, their types, and prevalence, to recognize the risk factors and causes of irregular menstruation, and to understand their impact on women's health.
