Definition

Polymenorrhea is a condition characterized by a menstrual cycle that is too short, specifically less than 21 days. Typically, the menstrual cycle lasts between 24 and 38 days, with an average of 28 days, and menstruation lasts 2–8 days.

Polymenorrhea is a form of abnormal uterine bleeding. For some women, a short menstrual cycle is normal, but for others, it may be caused by certain medical conditions.

There are two reasons why polymenorrhea may affect fertility. First, the process of producing egg cells, known as ovulation, occurs faster than expected, resulting in the formation of abnormal (irregular) egg cells. Second, the time between ovulation and menstruation may be too short for fertilization and embryo development to occur.

Causes

Often, the exact cause of polymenorrhea is unknown. One cause is hormonal imbalances that speed up the egg formation process, leading to a shorter menstrual cycle and more frequent menstruation.

Other possible causes of polymenorrhea include:

• Stress
• Infections and sexually transmitted diseases
• Endometriosis
• Menopause

Risk Factor

Several factors can increase the risk of polymenorrhea, including:

• Age
• Women approaching menopause, typically in their late 40s and early 50s, experience significant hormonal changes that can lead to depression, mood changes, and changes in the menstrual cycle.
• Hormonal imbalance
• This can be caused by conditions such as Polycystic Ovary Syndrome (PCOS), thyroid disease, and lack of ovulation
• Use of birth control pills or hormonal medications
• Excess weight or obesity
• Abnormal uterine structure
• Abnormalities in the uterus, such as polyps, fibroids, and adenomyosis
• Cancers
• Conditions such as vaginal cancer, uterine cancer, cervical cancer, or endometrial hyperplasia can lead to abnormal uterine bleeding
• Infections such as trichomoniasis, chlamydia, gonorrhea, and vaginitis
• Other health conditions, such as kidney failure, liver failure, pelvic inflammatory disease, leukemia, and other blood disorders

Symptoms

The primary symptom of polymenorrhea is frequent menstrual periods and a short menstrual cycle. Other symptoms include:

• A menstrual cycle shorter than 21 days
• Increased frequency of menstruation, sometimes more than 1-2 times a month
• Prolonged duration of menstruation
• Increased blood volume, leading to heavy bleeding
• In severe cases, polymenorrhea can lead to anemia due to frequent and heavy bleeding

Diagnosis

Polymenorrhea is diagnosed through a medical examination. The doctor will ask questions about your symptoms, the length of your menstrual cycle, and the duration of your periods.

Additionally, the doctor may recommend some tests and referrals to a gynecologist or other specialists depending on your symptoms.

Several additional tests that may be conducted include:

• Complete blood tests, including hormone tests such as progesterone, LH, FSH, and prolactin
• Ultrasound examination
• Hysteroscopy
• Endometrial biopsy
• CT scan

Management

Treatment for polymenorrhea depends on the underlying cause. In general, polymenorrhea is temporary and treatable. Treatment will consider the cause, age, health risks, and contraceptive options.

Hormonal therapy, including estrogen and combination therapies (estrogen and progesterone), is one treatment option, along with iron supplements to help treat anemia.

Complications

Women with polymenorrhea may develop anemia due to frequent and heavy bleeding. This condition occurs when the blood lacks enough healthy red blood cells.

Symptoms of anemia include fatigue, difficulty remembering and concentrating, weakness, dizziness, and pale skin. Some women may also experience bloating and fluid retention during their menstrual periods.

Prevention

You can reduce the risk of polymenorrhea by:

• Maintaining an ideal body weight helps balance reproductive hormones.
• Managing stress.
• Regular exercise.
• Eating a balanced diet.
• Keeping a record of your menstrual cycle and duration.

If you plan to become pregnant, consult your doctor about treatment options for polymenorrhea.

When to See a Doctor?

Contact your doctor if you have irregular menstrual cycles to determine whether it is normal or if there is an underlying cause that requires treatment.

See a doctor immediately if you experience anemia due to polymenorrhea so that appropriate treatment can be provided. Inform your doctor if you plan to become pregnant, as this will influence the treatment options.

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