Polymenorrhea is a term for frequent, short menstrual cycles. This can occur naturally, but in some cases, it is a symptom of an underlying issue.
This article looks at what the condition is, why it happens, treatments, and its relationship to pregnancy.
Polymenorrhea describes when a person’s menstrual periods are normal in terms of volume of blood flow, but occur at intervals of less than 21 days.
According to the National Institutes of Health (NIH), a typical menstrual cycle lasts between 21–35 days, with bleeding between 2–6 days. The bleeding is when a person’s period occurs. According to another report, an average volume of blood loss is 20–80 milliliters (ml).
A medical professional considers a person’s cycle to be irregular if there is a significant variation in the length of the cycle. A medical professional may describe this as ‘abnormal uterine bleeding’ if the person is not pregnant.
Having more frequent periods and shorter cycles than usual could mean that a person has polymenorrhea. Some people may also become aware of this if they experience difficulties becoming pregnant.
If a person notices any other symptoms that may suggest an underlying condition, they should consult a doctor.
People who have polymenorrhea may find it more difficult to get pregnant.
Ovulation occurs when the ovaries release an egg. In polymenorrhea, this may occur earlier than usual or happen at irregular times during the cycle. Also, some people may have a shorter luteal phase. The luteal phase is when the body is preparing for pregnancy.
A 2016 study indicated that women aged 21–45 who were trying to get pregnant had less chance of conceiving in one menstrual cycle if their cycle was less than 26 days.
Another study of women aged 19-41 found that women with high menstrual cycle variability had a 51% lower probability of pregnancy per cycle.
Some people naturally have unusual menstrual cycle lengths, and this may be normal for them.
However, irregular cycles could indicate an underlying cause. A person should always seek medical advice to clarify this.
In 2011, the International Federation of Gynecology and Obstetrics (FIGO) proposed the PALM-COEIN scheme to classify disorders causing abnormal uterine bleeding. However, health specialists should only use the system on people whose irregular bleeding is not related to pregnancy. According to PALM-COEIN, possible causes can be either structural, such as polyps or malignancies, or non-structural, such as ovulatory causes.
Some of the causes of abnormal uterine bleeding, according to a 2016 review, may include:
- adenomyosis, a condition in which the inner lining of the uterus breaks through the muscle wall of the uterus
- malignancy, which is the presence of cancer or a malignant tumor
- coagulopathy, a condition in which the blood has a reduced ability to clot
- ovulatory causes
- endometrial causes
- iatrogenic causes, which are due to diagnostic procedures, or treatments, such as intrauterine device (IUD) or hormone medications, such as birth control
- not otherwise classified causes that may co-exist with abnormal uterine bleeding
At certain times in a person’s life, menstrual cycles may become irregular. This can happen when they first start menstruating during puberty, or when they are coming towards the end of menstruation during menopause.
Changes in the menstrual cycle can occur during perimenopause, which is the time leading up to menopause. Other symptoms may include hot flashes, mood swings, weight changes, and fatigue. Many people notice perimenopause symptoms in their 40s, but some can have them as early as their 30s.
A consultation with a medical practitioner can help a person find out if their symptoms and menstrual irregularities are because of perimenopause. Sometimes a doctor will request blood tests to confirm this.
Stress can impact hormones. A 2018 study of female students aged 18–25 in Saudi Arabia indicated that 91% had some menstrual problems, and 27% had irregular menstruation. 39% of the students were experiencing high perceived stress.
A person who feels they are stressed should talk to their doctor and may want to see a psychological therapist for support.
Treatment depends on the cause of polymenorrhea. A review of abnormal uterine bleeding recommends individualized treatment, and no one-size-fits-all approaches are available.
Management of the condition should consider a person’s fertility desire and contraceptive needs, the impact of symptoms, other conditions present, and any other contributing factors.
Abnormal uterine bleeding that becomes heavy could indicate fibroids or endometrial complications. In some cases, abnormal uterine bleeding could indicate endometrial or uterine cancer.
A person who feels fatigued, weak, or tired should see a doctor, as they could have anemia. Anemia is when a person lacks enough healthy red blood cells to carry oxygen around their body.
People who have shortened or too frequent menstrual cycles should consult a medical professional to get a diagnosis. This may involve questions, examinations, or tests. Depending on any other accompanying symptoms, a doctor may refer a person to a gynecologist or other specialist for further investigation.
According to the American College of Obstetricians and Gynecologists (ACOG), doctors may recommend the following tests:
- an ultrasound exam
- a hysteroscopy, which is a thin, lighted scope that investigates the uterus
- an endometrial biopsy, which involves removing a sample from the lining of the uterus
- a sonohysterography, which produces ultrasound images of a fluid-filled uterus
- a CT scan, which is an X-ray procedure
If someone has irregular menstrual cycles, they should see a doctor who can confirm whether this is natural for them or if there is an underlying cause that needs treatment. They may also want to talk about how the condition is impacting their life.
Shortened or too frequent menstrual cycles may impact a person’s life in many ways, including affecting their social life and mental health.
A doctor must also investigate any additional symptoms that accompany irregular cycles.
Polymenorrhea can be due to a person’s natural cycle or may have underlying causes. A person needs to find out why their cycle is irregular. They should see a medical professional for advice and possibly investigations and treatment.
Sometimes stress may be at the root of menstrual irregularities, and anyone experiencing stress should address this with a medical professional.
Polymenorrhea can severely affect a person’s life and may impact their work or school life, social life, activities, and the way they feel.
If a person wants to become pregnant, as well as seeking their doctor’s advice, they may want to use a smartphone app to track their menstrual cycles.