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Polymenorrhea

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Polymenorrhea
Other namesPolymenorrhoea; Polymenorrhœa; Frequent periods; Frequent menstrual bleeding; Frequent menstruation; Epimenorrhea; Epimenorrhoea; Epimenorrhœa; Abnormally frequent menstruation; Unusually frequent menses
SpecialtyGynecology
SymptomsShort menstrual cycles (<21 days) that are otherwise regular and normal
ComplicationsAnemia; Iron deficiency; Endometrial cancer (when related to inadequate luteal phase)
CausesAnovulation; Inadequate/short luteal phase; Short follicular phase; Certain endocrine disorders; Puberty/adolescence; Perimenopause
Differential diagnosisMetrorrhagia (intermenstrual bleeding)
TreatmentHormonal agents
MedicationProgestogen during luteal phase; Combined oral contraceptive pill
PrognosisUsually transient and self-limited

Polymenorrhea, also known as frequent periods, frequent menstruation, or frequent menstrual bleeding, is a menstrual disorder in which menstrual cycles are shorter than 21 days in length and hence where menstruation occurs more frequently than usual.[1][2][3] Cycles are regular and menstrual flow is normal in the condition.[3] Normally, menstrual cycles are 25 to 30 days in length, with a median duration of 28 days.[2]

Polymenorrhea is usually caused by anovulation (failure to ovulate), an inadequate or short luteal phase, and/or a short follicular phase.[4][3][5] Polymenorrhea is common in puberty and adolescence due to the immaturity of the hypothalamic–pituitary–gonadal axis (HPG axis).[4] Shorter menstrual cycles are also common in the early perimenopause (menopausal transition), during which time the lengths of menstrual cycles may be reduced by 3 to 7 days secondary to a shorter follicular phase.[6][7] Certain endocrine disorders, such as hyperprolactinemia, hypothyroidism, hyperthyroidism, Cushing's syndrome, and acromegaly, can cause polymenorrhea.[8][9][additional citation(s) needed] While not a classical symptom, polymenorrhea can occur as a result of uterine fibroids.[10] Polymenorrhea may result in anemia and iron deficiency due to blood loss.[4] In addition, when it is due to an inadequate luteal phase and hence progesterone deficiency, polymenorrhea may be related to an increased risk of endometrial cancer.[11]

Polymenorrhea is usually transient and self-limited, thereby not necessitating treatment.[4] If it persists, is disturbing, or if there is considerable blood loss due to the frequent periods, treatment may be indicated.[4] The mainstays of treatment are a progestogen during the luteal phase of the cycle or a combined oral contraceptive pill.[4]

Polymenorrhea is sometimes confused with metrorrhagia (menstrual bleeding between periods).[3] It can be distinguished from metrorrhagia by its regularity.[3] Polymenorrhea can be contrasted with oligomenorrhea, in which menstrual cycles are greater than 35 or 37 days in length.[3][12] The condition can also be distinguished from polymenorrhagia, which is a combination of polymenorrhea and menorrhagia (heavy menstrual bleeding).[1]

References

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  1. ^ a b Woolcock JG, Critchley HO, Munro MG, Broder MS, Fraser IS (December 2008). "Review of the confusion in current and historical terminology and definitions for disturbances of menstrual bleeding". Fertil Steril. 90 (6): 2269–80. doi:10.1016/j.fertnstert.2007.10.060. PMID 18258230.
  2. ^ a b Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K, Dungan K, Hershman JM, Hofland J, Kalra S, Kaltsas G, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, Levy M, McGee EA, McLachlan R, Morley JE, New M, Purnell J, Sahay R, Singer F, Sperling MA, Stratakis CA, Trence DL, Wilson DP, Reed BG, Carr BR (5 August 2018). "The Normal Menstrual Cycle and the Control of Ovulation". Endotext. PMID 25905282.
  3. ^ a b c d e f Tamara Callahan; Aaron B. Caughey (28 January 2013). Blueprints Obstetrics and Gynecology. Lippincott Williams & Wilkins. pp. 296–. ISBN 978-1-4511-1702-8. OCLC 1023316161.
  4. ^ a b c d e f Tscherne G (2004). "Menstrual irregularities. Evidence-based clinical practice". Endocr Dev. 7: 129–39. doi:10.1159/000077081. PMID 15045790.
  5. ^ Oriel KA, Schrager S (October 1999). "Abnormal uterine bleeding". Am Fam Physician. 60 (5): 1371–80, discussion 1381–2. PMID 10524483.
  6. ^ Goldstein SR (February 2004). "Menorrhagia and abnormal bleeding before the menopause". Best Pract Res Clin Obstet Gynaecol. 18 (1): 59–69. doi:10.1016/j.bpobgyn.2003.10.003. PMID 15123058.
  7. ^ Prior JC (2002). "The ageing female reproductive axis II: Ovulatory changes with perimenopause". Endocrine Facets of Ageing. Novartis Foundation Symposia. Vol. 242. pp. 172–86, discussion 186–92. doi:10.1002/0470846542.ch11. ISBN 9780471486367. PMID 11855687.
  8. ^ Unuane, David; Tournaye, Herman; Velkeniers, Brigitte; Poppe, Kris (December 2011). "Endocrine disorders & female infertility". Best Practice & Research Clinical Endocrinology & Metabolism. 25 (6): 861–873. doi:10.1016/j.beem.2011.08.001. ISSN 1521-690X. PMID 22115162.
  9. ^ Kalro, Brinda N (September 2003). "Impaired fertility caused by endocrine dysfunction in women". Endocrinology and Metabolism Clinics of North America. 32 (3): 573–592. doi:10.1016/S0889-8529(03)00041-0. ISSN 0889-8529. PMID 14575026.
  10. ^ Swaraj Batra (2011). Case Discussions in Obstetrics and Gynecology. Jaypee Brothers Medical Publishers Pvt. Ltd. pp. 231–. ISBN 9789350258484. OCLC 856017557.
  11. ^ Schindler AE (April 2009). "Progestogen deficiency and endometrial cancer risk". Maturitas. 62 (4): 334–7. doi:10.1016/j.maturitas.2008.12.018. PMID 19231117.
  12. ^ Walker HK, Hall WD, Hurst JW, Long WN (1990). Abnormal Vaginal Bleeding. Butterworths. ISBN 9780409900774. PMID 21250125.


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