How to identify signs of pregnancy with irregular periods

When periods come at irregular intervals, it makes it difficult to predict when the next menstrual cycle will start. If you are sexually active and have irregular periods due to hormonal imbalance or Polycystic Ovary Syndrome, you may have another problem. It can be difficult for you to figure out if you are pregnant or not. While missed period is one of the most common signs of pregnancy, there are other ways to know if you are expecting or not. Morning sickness and breast tenderness are other common pregnancy symptoms. These signs of pregnancy can help even if you have irregular periods.

What are irregular periods?

Irregular periods refer to menstrual cycles that vary significantly in length, timing, or flow compared to a normal cycle. “A menstrual cycle usually lasts between 25 to 35 days with a flow ranging from 2 to 7 days and an average of 50 to 80 ml of blood loss,” shares gynaecologist and fertility expert Dr Gurpreet Batra. The prevalence of irregular periods among women across the globe ranges from 5 to 35.6 percent, according to a 2023 study published in Cureus.

Why do women have irregular periods?

Women may experience irregular periods for a variety of reasons. These include:

• Fluctuations in hormones like estrogen and progesterone during puberty, perimenopause, or early menopause can affect the regularity of the menstrual cycle.
• Polycystic Ovary Syndrome or PCOS is a hormonal disorder that can disrupt ovulation, leading to irregular or missed periods.
• Both hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) can interfere with the menstrual cycle, as the thyroid helps regulate hormone production.
• High levels of emotional or physical stress can disrupt the hypothalamus, the brain region that controls hormone production, affecting menstruation.
• Intense physical activity or significant weight loss can lower estrogen levels, which may result in missed or irregular periods.
• Being overweight can lead to an excess of estrogen, which may cause irregular periods.
• Health issues like diabetes, celiac disease, or chronic illnesses can interfere with the body’s normal hormone production and menstrual cycles.

Do irregular periods impact fertility?

Irregular periods may have a link to fertility problems such as pregnancy complications, and poor maternal health, as per research published in Epidemiology in 2009.

“Irregular periods can impact fertility in a negative way, as they indicate irregular or absent ovulation,” says Dr Gurpreet Batra. Since ovulation is crucial for conception (the release of an egg from the ovary), not ovulating regularly can make it more difficult to become pregnant. Irregular menstrual cycles can make it challenging to predict the most fertile days for sex.

“Even though there are challenges, many women with irregular periods can still conceive, often with the help of medical interventions or treatments,” Dr Batra adds.

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What are the signs of pregnancy if you have irregular periods?

A missed period is the most reliable sign of pregnancy for women who have regular periods, according to the UK’s National Health Service. But if you have irregular periods, look for these signs:

1. Breast tenderness

Hormonal changes in early pregnancy can cause swelling and sensitivity in one or both your breasts. “These changes can make your breasts feel tender or sore,” says the expert.

2. Fatigue

Progesterone levels shoot up different stages of life, including early pregnancy. This often leads to a feeling of extreme tiredness or fatigue even though you had a good night’s sleep or didn’t exert yourself.

3. Nausea and vomiting

Morning sickness, nausea and vomiting during pregnancy, is a common sign that indicates you are pregnant. You can start experiencing it as early as two weeks after conception, and can occur at any time of the day.

4. Frequent urination

If you are pregnant, the blood flow to your kidneys will increase. “Due to this, you will feel like urinating more often, as your body processes extra fluids,” says the expert.

5. Mood swings

Hormonal fluctuations can lead to not just physical changes, but also emotional ones and mood swings. These signs are similar to those experienced before menstruation, but they are often more pronounced during pregnancy.

6. Food cravings or aversions

During pregnancy, you may no longer enjoy certain foods you used to like earlier. You may also develop strong cravings for certain foods apart from aversions. Strange tastes, and smells are other symptoms.

7. Light spotting

If not regular symptoms, you may experience light spotting around 6 to 12 days after conception. “This is the time when the fertilised egg gets implanted in the uterine lining,” says the expert.

8. Bloating and constipation

Hormonal changes can affect your digestion, by slowing it down, and causing bloating and constipation. These may be more noticeable than typical menstrual symptoms.

For women with irregular periods, pinpointing when to take a pregnancy test can be tricky. If you experience any of these pregnancy signs, consider testing at that time. “You can also wait for at least 36 days from the start of your last period or about two weeks after you have had sex to take a pregnancy test,” says the expert.

How to treat irregular periods?

If you have irregular periods and want to conceive, these treatment options can help regulate cycles:

• Maintain a healthy weight, as achieving a healthy weight can balance hormones and regulate periods.
• Managing stress through relaxation techniques like yoga, listening to music or meditation can help restore menstrual regularity.
• Proper nutrition and moderate exercise can improve menstrual health.
• Clomiphene Citrate is a drug that induces ovulation and is often prescribed to women with PCOS or irregular periods.
• Progesterone supplements can help induce regular periods, especially if there is a hormonal imbalance.
• Treat underlying conditions like PCOS through lifestyle changes or medications like metformin can regulate cycles and improve fertility.

In the case of irregular periods, it may be challenging to determine the exact timing of ovulation. So, it is important to consider the signs of pregnancy before taking a pregnancy test.