Hormonal Imbalance: When Should Irregular Periods Be a Concern?

Irregular periods are normal, as each woman’s cycle differs from another. But when should you be concerned? Take this quiz to find out.

Woman staring at calendar noting her menstrual cycle.

Every woman is unique, and so is her menstrual cycle. However, irregular periods could also be a sign of hormonal imbalance, a condition that affects 80% of women aorund the world. In some cases, the situation is mild, and some lifestyle changes can get you back on track. In other cases, it could be a sign of a serious disease.

For example, it has been estimated that about 75% of women who visit their doctors have undiagnosed PCOS (polycystic ovary syndrome), with irregular periods being one of the symptoms. Take our quiz to find out if your irregular period should be a cause for concern. 

Quiz questions: 

  1. For the last 6 months or so, how often do you get your period?
    a. It varies, somewhere between 21 – 35 days 
    b. My cycle is short – I get my period every 2-3 weeks
    c. My cycle is long – I get my period every 5-6 weeks (some months, not at all) 
  2. Did you just start your period? (age 11 to 15 years old) 
    a. Yes 
    b. No
  3. Are you approaching the age group that some women usually experience perimenopause (mid-40s) or menopause (late 40s to early 50s)? 
    a. Yes 
    b. No
  4. Are you pregnant? 
    a. Yes 
    b. No
  5. Do you use hormonal birth control? (pill, patch, or hormonal IUD)?
    a. Yes 
    b. No
  6. Are you at a healthy weight?  
    a. Yes, I fall within a healthy BMI of 18.5 – 24.9 (Body Mass Index) 
    b. No, I am underweight / overweight 
  7. Do you have / Have you had trouble conceiving? 
    a. No, I have been successful 
    b. Yes, I have infertility challenges
  8. Do you experience pelvic or abdominal pain near the time of or during your period? 
    a. Yes, but nothing too extreme  
    b. Yes, so much so that I sometimes have to miss school or work
    c. No
  9. Do you also have the following conditions: insulin resistance, prediabetes, or diabetes? 
    a. No, I am not aware that I have these conditions 
    b. Yes, I have one of these metabolic conditions
  10. When you do get your period, do you have heavy flow? (Have to change your pad or tampon every 2-3 hours.) 
    a. No, the flow feels normal, maybe some days are heavier
    b. Yes, a few or all of the days
    c. No, my flow is not heavy – in fact it feels too light

Find Out What Your Irregular Periods Could Mean 

Illustration of uterine fibroids
Hormonal imbalances can lead to conditions such as uterine fibroids that can cause irregular periods

So many things can affect your cycle, from your stress level to a potential physical anomaly inside that you’re not aware of. Let’s see what your answers tell us. 

If your answers are mostly A’s: You might be experiencing temporary irregularity  

You may be experiencing some hormonal changes that are causing your irregular periods. This can happen in early puberty, for example, when your body is still adjusting. Or if you are in your forties to early fifties, and experiencing other symptoms of perimenopause or menopause.

In early pregnancy, your body may take time to stop menstruating. On the other hand, if you’re trying to prevent pregnancy by using hormonal birth control methods such as the pill, patch, or hormonal IUD, your irregular periods could be a sign that your body is slowly adjusting to the synthetic hormones. 

Lifestyle can be a factor too. High stress increases cortisol, which can cause certain parts of your body like your reproductive system to stop working. Once your stress level stabilises, your period may go back to its normal cycle. 

If your answers are mostly B’s and C’s: You might have hormonal imbalance that requires medical evaluation 

If your irregular periods are accompanied by other risk factors and you can’t seem to get a sense of normalcy, then you could have one or more medical conditions – such as hormonal imbalance.

Hormonal imbalance is when the ovaries produce an excess of male (androgen) hormones and can prevent ovulation during each menstrual cycle. Another condition associated with hormone imbalance – specifically oestrogen dominance and progesterone resistance – is endometriosis where cells that normally grow on the uterine lining (endometrium) are found outside of the uterus. This condition causes heavy and prolonged bleeding as well as extreme pain during menstruation.

Uterine fibroids and uterine polyps are also associated with oestrogen dominance, and can cause irregular periods and difficulty in conceiving. Treatment for these conditions may include hormone treatments to address the specific hormonal imbalance. 

The TCM Perspective on Hormonal Imbalance 

Fresh dong quai roots laid out in woven basket
Angelica sinensis (dong quai, 当归) is a common TCM herb used to treat hormonal imbalance.

In Traditional Chinese Medicine (TCM), hormonal imbalances that lead to irregular periods could be caused by three conditions: Kidney Deficiency, Spleen Deficiency, or Liver Stagnation.

“The Kidney’s qi (vital energy) and jing (essence) are the roots of a woman’s period and her reproductive system,” TCM physician Ho Li Ying explains. A deficiency in the Kidney can directly affect her period. Overworking, excessive sex, staying up late – these contribute to a Kidney qi Deficiency. Symptoms may include lower back pain, especially before or during periods, hypomenorrhea, light red menstrual blood, tinnitus, dizziness, and nocturia. 

“Meanwhile Deficiency in Spleen causes Phlegm-Dampness, slow metabolism, and Stagnation of qi and blood, as well as Deficiency in qi and blood,” she further elaborates. An erratic diet such as consuming excessive cold or oily food and drinks, overworking and emotional imbalances such as anxiety and overthinking can all lead to Deficiency in Spleen. Symptoms include tiredness, dizziness, hypermenorrhea, and loose stools, with a tendency to either gain weight easily or being underweight. 

“Liver Stagnation is mainly affected by emotions such as anger, depression, or stress. These emotions cause Stagnation in the Liver qi, affecting qi and blood circulation, resulting in irregular periods,” Physician Ho explains. Other symptoms include period pain, delayed menstruation, insomnia, bloating in stomach or abdomen, headache, or breast tenderness especially before the period. 

How TCM Corrects Hormonal Imbalance 

Bak foong pill is a TCM formulation aimed at improving Kidney and Spleen, as well as qi and blood. It has been shown to effectively reduce excessive male hormones when used with metformin in animal models. TCM formulations containing herbs such as Radix Angelica sinensis, Rhizoma chuanxiong, and Fructus Jujubae are known to help menstrual blood flow. They can also be found in easy-to-consume supplement drinks.

While studies are still ongoing regarding the exact mechanism of acupuncture, some show that acupuncture is associated with hormonal changes in treating menstrual disorders. To further promote hormonal balance, Physician Ho recommends the following: 

  • Practice a balanced diet  
  • Avoid cold food and drinks 
  • Maintain healthy sleep (go to bed before 11pm) 
  • Exercise regularly 
  • Manage stress levels and bad emotions 

Hormonal balance is a key aspect of everyone’s health, especially for women as hormones govern their reproductive system. It helps to know whether your irregular period is temporary and can be addressed by changing your lifestyle choices, or whether you should go for further medical evaluation to rule out more serious illnesses. 

References

  1. International Journal of Environmental Research and Public Health. 2018. Geographical Prevalence of Polycystic Ovary Syndrome as Determined by Region and Race/Ethnicity. [online] [Accessed 27 March 2022]. 
  2. National Health Service (NHS). 2021. Irregular periods. [online] [Accessed 27 March 2022]. 
  3. Cleveland Clinic. 2020. Can Stress Cause You to Skip a Period? [online] [Accessed 27 March 2022]. 
  4. Frontiers in Endocrinology. 2020. Regulation of Inflammation Pathways and Inflammasome by Sex Steroid Hormones in Endometriosis. [online] [Accessed 27 March 2022]. 
  5. Cleveland Clinic. 2018. Uterine Polyps. [online] [Accessed 27 March 2022]. 
  6. Northwell Health. 2018. 11 unexpected signs of hormonal imbalance. [online] [Accessed 27 March 2022]. 
  7. Oncology Letters. 2015. Bak Foong pills combined with metformin in the treatment of a polycystic ovarian syndrome rat model. [online] [Accessed 27 March 2022]. 
  8. Evidence-Based Complementary and Alternative Medicine. 2018. A Literature Review of Women’s Sex Hormone Changes by Acupuncture Treatment: Analysis of Human and Animal Studies. [online] [Accessed 27 March 2022]. 

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