The menstrual cycle is directed by a precise balance of hormones. Normally, an egg develops each month in the ovary and releases--a process called ovulation. Approximately two weeks after ovulation, menstrual bleeding begins as hormone levels drop and the uterine lining breaks down. The menstrual cycle usually lasts between 25 and 36 days, with an average of 28 days, although only 10 percent of women have 28-day cycles, The Merck Manuals Online Medical Library reports. Some women have very short or abnormally long cycles and may need treatment, especially if they're trying to get pregnant.
Treatment Purpose
Irregular menstrual cycles make it difficult for a woman to become pregnant. In many cases, women with irregular cycles don't ovulate on a regular basis and may not ovulate at all. Unless an egg releases from the ovary, a woman has no chance of getting pregnant. Irregular menstrual cycles can also cause the uterine lining to build up and become thicker than normal, a condition known as hyperplasia. An unusually thick uterine lining can predispose a woman to developing uterine cancer. If the lining thickens too much, periods can become extremely heavy and a woman can develop anemia.
Lifestyle Changes
Most treatments for irregular menstrual cycles regulate hormone levels so the body will respond normally. Treatments consist of lifestyle changes, medications or surgery. In some cases, a woman doesn't ovulate because she's overweight, which can change the hormone balance in the body. Losing as little as 5 to 10 percent of body weight can help regulate hormone levels, Dr. Corrine Welt of Harvard Medical School explains on UpToDate. On the other hand, some women don't ovulate because they're too thin, weighing 10 percent less than normal or because they exercise too strenuously, which interferes with the release of hormones from the pituitary gland. Gaining weight and reducing the amount of exercise helps regulate their menstrual cycles.
Medical Treatments
Oral contraceptives or other combinations of estrogen and progesterone can cause a normal period each month to avoid an overly thick uterine lining from developing. Women who have polycystic ovary syndrome, or PCOS, have an excess of male hormones, called androgens, which suppress ovulation. Reducing androgen levels with medications such as metformin can induce regular menstrual cycles. Women with benign pituitary tumors that secrete the hormone prolactin may also have irregular or absent cycles. Medications to reduce prolactin levels, called dopamine agonists, can help regulate cycles. Surgery can remove tumors that don't respond to medication or if a woman wants to get pregnant, because medications can't be taken during pregnancy, states endocrinologist Dr. Peter Snyder of the University of Pennsylvania, also writing on UpToDate.
Evaluation
Blood tests can evaluate the effectiveness of treatment, especially for women trying to get pregnant. A rise in estrogen levels over the first half of the menstrual cycle followed by a rise in progesterone levels in the second half of the cycle indicates normal functioning of the ovary with the development and release of an egg. In women not trying to get pregnant, having a withdrawal bleed each month while taking hormone replacement treatment indicates effective treatment.
Considerations
Irregular menstrual cycles can prevent pregnancy, increase the chance of developing uterine cancer and indicate health problems that need medical attention. Whether or not a woman wants to get pregnant will dictate the particular treatment of irregular menstrual cycles.
