| Polymenorrhea | |
|---|---|
| Other names | Polymenorrhoea; Polymenorrhœa; Frequent periods; Frequent menstrual bleeding; Frequent menstruation; Epimenorrhea; Epimenorrhoea; Epimenorrhœa; Abnormally frequent menstruation; Unusually frequent menses |
| Specialty | Gynecology |
| Symptoms | Short menstrual cycles (<21 days) that are otherwise regular and normal |
| Complications | Anemia;Iron deficiency;Endometrial cancer (when related to inadequate luteal phase) |
| Causes | Anovulation; Inadequate/shortluteal phase; Shortfollicular phase; Certainendocrine disorders;Puberty/adolescence;Perimenopause |
| Differential diagnosis | Metrorrhagia (intermenstrual bleeding) |
| Treatment | Hormonal agents |
| Medication | Progestogen duringluteal phase;Combined oral contraceptive pill |
| Prognosis | Usually transient and self-limited |
Polymenorrhea, also known asfrequent periods,frequent menstruation, orfrequent menstrual bleeding, is amenstrual disorder in whichmenstrual cycles are shorter than 21 days in length and hence wheremenstruation occurs more frequently than usual.[1][2][3] Cycles are regular and menstrual flow is normal in the condition.[3] Normally, menstrual cycles are 25 to 30 days in length, with a median duration of 28 days.[2]
Polymenorrhea is usually caused byanovulation (failure to ovulate), an inadequate or shortluteal phase, and/or a shortfollicular phase.[4][3][5] Polymenorrhea is common inpuberty and adolescence due to the immaturity of thehypothalamic–pituitary–gonadal axis (HPG axis).[4] Shorter menstrual cycles are also common in the earlyperimenopause (menopausal transition), during which time the lengths of menstrual cycles may be reduced by 3 to 7 days secondary to a shorter follicular phase.[6][7] Certainendocrine disorders, such ashyperprolactinemia,hypothyroidism,hyperthyroidism,Cushing's syndrome, andacromegaly, can cause polymenorrhea.[8][9][additional citation(s) needed] While not a classical symptom, polymenorrhea can occur as a result ofuterine fibroids.[10] Polymenorrhea may result inanemia andiron deficiency due toblood loss.[4] In addition, when it is due to an inadequate luteal phase and henceprogesterone deficiency, polymenorrhea may be related to an increased risk ofendometrial cancer.[11]
Polymenorrhea is usually transient and self-limited, thereby not necessitating treatment.[4] If it persists, is disturbing, or if there is considerable blood loss due to the frequent periods, treatment may be indicated.[4] The mainstays of treatment are aprogestogen during the luteal phase of the cycle or acombined oral contraceptive pill.[4]
Polymenorrhea is sometimes confused withmetrorrhagia (menstrual bleeding between periods).[3] It can be distinguished from metrorrhagia by its regularity.[3] Polymenorrhea can be contrasted witholigomenorrhea, in which menstrual cycles are greater than 35 or 37 days in length.[3][12] The condition can also be distinguished frompolymenorrhagia, which is a combination of polymenorrhea andmenorrhagia (heavy menstrual bleeding).[1]