- Also spelled:
- oligomenorrhoea
- Related Topics:
- menstrual cycle
oligomenorrhea
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What is oligomenorrhea?
Oligomenorrhea refers to prolonged intervals between menstrual cycles. In this condition, menstruation occurs at intervals greater than 35 days, typically 4 to 9 times per year, as opposed to the usual 25 to 30 days.
Oligomenorrhea can lead to infertility and may present estrogen deficiency symptoms like vaginal dryness, loss of libido, hot flashes, and breast atrophy. It arises from ovarian, pituitary, or hypothalamic dysfunction. Treatment is based on the cause and the woman's desire for fertility. Progestin may be administered, and if fertility is not desired, oral contraceptives may be given.
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How is a normal menstrual cycle different from oligomenorrhea?
In a typical menstrual cycle, which recurs until about age 50 (menopause), women of reproductive age menstruate about every 25 to 30 days. By contrast, oligomenorrhea is a condition characterized by infrequent menstrual periods, occurring at intervals greater than 35 days. Women with oligomenorrhea typically menstruate between 4 and 9 times a year. In the event that menstruation ceases altogether, the condition is called amenorrhea.
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What are some common causes of oligomenorrhea?
Oligomenorrhea is a condition marked by infrequent menstrual periods, occurring at intervals greater than 35 days. Common causes include hypothalamic, pituitary, or ovarian dysfunction.
Hypothalamic issues can stem from psychological or emotional disorders, chronic illnesses, starvation, or excessive exercise, leading to decreased secretion of gonadotropin-releasing hormone (GnRH). Pituitary causes involve hyperprolactinemia or gonadotropin deficiency, potentially due to nonsecreting pituitary tumors. Ovarian causes encompass autoimmune premature ovarian failure, surgical removal, or radiation.
Additional factors include certain drugs, hormones, and androgen excess, as seen in polycystic ovary syndrome (PCOS). PCOS is often associated with obesity and insulin resistance, further contributing to menstrual irregularities.
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How can hormonal problems lead to oligomenorrhea?
Hormonal imbalances can significantly disrupt the menstrual cycle, leading to oligomenorrhea, which is characterized by infrequent menstruation. Conditions such as polycystic ovary syndrome (PCOS), a common cause of androgen excess in women, can cause irregular periods, including oligomenorrhea.
Oligomenorrhea can also stem from hypothalamic, pituitary, or ovarian dysfunction, which affects the hormones that regulate the menstrual cycle. For instance, decreased secretion of gonadotropin-releasing hormone (GnRH) or high serum prolactin concentrations can disrupt normal menstruation. Excess androgens, whether from adrenal disorders, ovarian disorders, or other sources, can also lead to oligomenorrhea.
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What health effects can result from having oligomenorrhea?
Oligomenorrhea refers to infrequent menstrual periods, occurring at intervals longer than 35 days.
Health effects that can result from oligomenorrhea:
* Infertility
* Symptoms of estrogen deficiency, such as loss of libido, breast atrophy, vaginal dryness, and hot flashes
* Excess hair growth (hirsutism)
* Virilization, which includes frontal balding, deepening of the voice, acne, clitoral enlargement, and increased muscle mass2 Britannica SourcesCreated from Britannica articles using AI. AI can make mistakes, so verify using Britannica articles. -
How do doctors diagnose and treat oligomenorrhea?
Oligomenorrhea is characterized by infrequent menstrual bleeding, with cycles exceeding 35 days. Diagnosis involves assessing a woman's medical history and physical examination. Blood tests measuring follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and testosterone levels can help reveal the cause. Imaging of the hypothalamus, pituitary gland, or ovaries may also provide additional information.
Treatment is based on the underlying cause and the woman's desire for fertility. Progestin administration may be used, and if bleeding occurs after stopping progestin, repeated courses may be administered. If fertility is not desired, a combination of estrogen and progestin or oral contraceptives may be prescribed. Clomiphene or gonadotropin injections can stimulate ovulation if fertility is desired.
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oligomenorrhea, prolonged intervals between menstrual cycles. Menstruation is the normal cyclic bleeding from the female reproductive tract. Most women of reproductive age menstruate every 25 to 30 days if they are not pregnant, nursing a child, or experiencing other disorders such as tumours, anorexia nervosa, or Stein-Leventhal syndrome (polycystic ovary syndrome). However, in oligomenorrhea, menstruation occurs in intervals greater than 35 days, and affected women typically menstruate between 4 and 9 times per year. If a woman fails to menstruate at all, the condition is referred to as amenorrhea.
Oligomenorrhea can result in infertility and may be accompanied by symptoms of estrogen deficiency, such as loss of libido, breast atrophy, vaginal dryness, and hot flashes. The causes of oligomenorrhea include hypothalamic, pituitary, or ovarian dysfunction. Hypothalamic amenorrhea is a term used to describe the condition of women who have oligomenorrhea or amenorrhea as a result of decreased pulsatile secretion of gonadotropin-releasing hormone (GnRH), which stimulates the synthesis and secretion of the two primary gonadotropins—luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Decreased GnRH secretion may be caused by psychological or emotional disorders (e.g., anorexia nervosa), chronic illnesses of nonendocrine organs (e.g., chronic liver, kidney, lung, or heart disease), starvation, or excessive exercise. Pituitary causes of oligomenorrhea include hyperprolactinemia (high serum prolactin concentrations), without or with galactorrhea (inappropriate lactation), and gonadotropin deficiency, such as that caused by a nonsecreting pituitary tumour or other disorder that results in decreased pituitary function.
Ovarian causes of oligomenorrhea include autoimmune premature ovarian failure, surgical removal of the ovaries, and radiation of the ovaries with X-rays. In addition, numerous drugs and hormones can inhibit the secretion of GnRH or gonadotropin or cause a decrease in ovarian function. For example, some psychoactive drugs cause hyperprolactinemia; glucocorticoids and androgens, whether taken for some therapeutic purpose or secreted in excess, inhibit gonadotropin secretion; and cyclophosphamide, an anticancer drug, causes ovarian deficiency.
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The cause of oligomenorrhea can often be determined from the woman’s history and a physical examination. Information about the cause of oligomenorrhea may be revealed by measurements of serum concentrations of FSH, LH, prolactin, and testosterone. Images of the hypothalamus and pituitary gland or the ovaries may provide additional information about the underlying cause. High serum FSH and LH concentrations indicate the presence of ovarian dysfunction (primary hypogonadism), whereas low concentrations indicate the presence of hypothalamic or pituitary dysfunction (secondary or central hypogonadism).
Treatment depends on the cause. If a specific cause cannot be corrected or if no cause is identified, then treatment will depend on the woman’s desire for fertility. Treatment may consist of administration of a progestin for 7 to 10 days. If vaginal bleeding occurs after the progestin is stopped, repeated courses of progestin may be administered and spontaneous menstrual cycles and ovulatory cycles may resume. If fertility is not desired, a combination of estrogen and progestin or an oral contraceptive may be given. If fertility is desired, clomiphene, which stimulates a surge in LH secretion, may successfully induce ovulation. Fertility may also be restored by gonadotropin injections to stimulate follicle maturation and ovulation.