What causes menstrual irregularities?

Menstrual irregularities can be caused by a variety of conditions, including pregnancy, hormonal imbalances, infections, malignancies, diseases, trauma, and certain medications
Common causes of anovulatory bleeding (absent, infrequent periods, and irregular periods) include

• Adolescence
• Uncontrolled diabetes 
• Eating disorders
• Hyperthyroidism or hypothyroidism
• Hyperprolactinemia (an abnormally high concentration in the blood of prolactin, a protein hormone)
• Medications, such as antiepileptics or antipsychotics
• Perimenopause
• Polycystic ovary syndrome (PCOS)
• Pregnancy

Common causes of ovulatory bleeding (heavy or prolonged menstrual bleeding) include

• Structural problems, such as uterine fibroids or polyps
• Bleeding disorders, such as leukemia, platelet disorders, the various factor deficiencies, or von Willebrand disease
• Hypothyroidism
• Advanced liver disease

Common causes of dysmenorrhea (menstrual pain) include

• Heavy menstrual flow
• Smoking
• Depression
• Never having given birth
• Endometriosis
• Chronic uterine infection

Additional causes of menstrual irregularity include:

• Endometriosis 
• Endocrine gland-related causes
  • Poorly controlled diabetes
  • Polycystic ovary syndrome (PCOS) 
  • Cushing's syndrome
  • Thyroid dysfunction 
  • Primary ovarian insufficiency (POI)
  • Late-onset congenital adrenal hyperplasia
• Acquired conditions
  • Stress-related hypothalamic dysfunction
  • Medications
  • Exercise-induced amenorrhea
  • Eating disorders (both anorexia and bulimia)
• Tumors
  • Ovarian
  • Adrenal
  • Prolactinomas (a noncancerous pituitary tumor that produces prolactin) 
  
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