Dr. Manjula Deepak

"The natural remedies for irregular periods depends on various things what you are going through. The first one is stress destressing is more easily said than done. Destressing in the form of reducing your work pressure. Doing yoga or regular exercise whatever you feel soothens your mind and body. Second is maintaining a healthy lifestyle and that depends on the way you eat your food, incorporating a lot of vitamins and antioxidants in your diet in the form of fruits and third is maintaining a basal metabolic index BMI is very important. To work on your BMI, most important is diet and regular exercise. The right amount of eating where you maintain your weight rather than binge eating and under eating is not acceptable. Never resort to any crash diet. Never resort to any tablets which would say you would loose your weight. Always do it in the right way, the harder way is sometimes the right way. Fourth way is some home remedies like ginger and cinnamon is very helpful in some patients. It relives your cramps and heavy cycles. Even green tea is known to reduce your menstrual cramps. Also Vitamin D3 deficiency is associated with irregular periods. So get your Vitamin D checked and if necessary take your supplements. Vitamin D and B12 is known to help you to cause you regular periods"

"Knowing the causes of irregular periods, the first one comes from the brain structure, that is thee hormones comes from the brain structures, that is the first hormone secreted for a regular periods is GnRH hormone in the pituitary and hypothalamus, so we there’s a problem, in the pituitary and hypothalamus, which is the commonly seen in stress related. Stress and your lifestyle modification can be directly proportional to distressing which can be in present day scenarios , a little bit of destressing exercises, yoga, menstruation, or you like just listening to music, travelling, whatever suits you. Second one being healthy lifestyle. Binge eating or overeating or undereating , both can be a cause. So a healthy lifestyle modification. Any tumors being diagnosed in the hypothalamo pituitary called as prolacatinoma. We have treatment for that called as bromocriptine depending on your hypothalamus status. Fourth is being we can go upto the level of surgery. So surgical treatment for tumors in the hypothalamus or pituitary glands. Coming to the thyroid, thyroid disorders can be corrected by treating your thyroid organs and eltroxin is the main hormone for correcting the thyroid conditions. Coming otto ovarian casue, depends on what cause it is if it is a tumor cause. Surgery is required. If it is just a polycystic ovarian disease, we have different method of treatment, most important is lifestyle modification where you are resort to healthy lifestyle healthy diet. Exercise, maintaining your BMI, is very important. Coming to PCOD, we have hormonal and non hormonal. Most of the times the treatment depends on the age of the woman and her reproductive status. If she is a young adult, we have just non hormonal treatment, if a woman is in her reproductive stage, we can resort to ovaries contraceptive tablets, we have lot of medications. These are all estrogen and progesterone hormone. If a woman is desirous for a pregnancy, then we induce ovulation. If the medication is resistant for irregular periods, then we have surgery in the form of ovarian drilling, or ovarian surgeries. So it all depends on the conditions we have diagnosed. Even TB or tuberculosis of the uterus may require ATT or antitubercular treatment can help you in treating these conditions"

"The cause for anovulation or why you are not ovulating depends on the factors that do not help in ovulation. So the factors can be hypothalamus and ovarian, that is the brain cause or an ovarian cause or a uterine cause. First is whenever your hormones are not secreted by our brain structure. So this can be as simple as stress related or eating disorders like excessive eating or excessive dieting or exercise like lack of exercise or over exercise. Third is any tumors in your brain like pituitary adenomas or pituitary tumors, even tuberculosis in your brain. Coming to pituitary gland tumors where we call a condition called as hyperprolactinomas. Under the influence of any antipsychotics or antihypertensive or thyroid disorders or diabetes, common to ovarian cause the commonest would be endometriosis, that is cyst in the ovaries or polycystic ovaries, or it could be any tumors in the ovaries or exposure to chemical or surgery in the ovaries or x - ray exposure to chemotherapies sand radiotherapies. These are some of the reasons for anovulation. Even ovarian tuberculosis can cause these conditions"

"Ovulation is directly proportional to regular periods. When a woman is regularly ovulating, she regularly menstruates. In irregular periods also she may ovulate. To understand this you need to know the signs of ovulation. There are certain direct methods to understand the direct methods of ovulation. At home methods first we have the BBT or the Basal body temperature. So first 15 days of the hormonal influence in the menstrual cycle is called as estrogen. That time our temperature we will be little low. Just around the 14th or the 15th day there is a rise in temperature because of ovulation, there is a production of hormone called as progesterone which increases the temperature by 0.5 to 1 degree centigrade. So we tell the woman to track her blood temperature from the 12th day to the 18th day so that there is a little bit of increase in your temperature. Second method is cervical mucus methods. We ask her to examine her mucus. The first 10 days is dry. The middle part is the wet period. From the 12th day to the 16th day because of ovulation, you have cervical mucus production which is a jelly like transparent materiel will be seen. This is a second sign. Third is called ovulation pain. In the mid cycle they feel a pain in the lower abdomen associated with a little bit of spotting. Apart from these three, if we want to confirm like in a case of irregular periods when your dates are not confirmatory is doing scans called as follicular scan. It is a scan where we track ovulation and monitor the growth of the eggs. This is follicular scan. The last method is called as laparoscopy. Doing a laparoscopy in the mid cycle we can see whether you are ovulating. Not all irregular periods are associated with anovualtion"

"Going back to the causes, most important are cerebral cortex, which hold hypothalamus and pituitary gland. Menstruation starts by a hormone secretion in the hypothalamus and pituitary called as GnRH hormone. Whenever there is a variation of these hormones there is a variation of estrogen and progesterone leading to irregular cycles. Stress doesn’t mean sleepless nights, emotional imbalance, psychological shock. Stress could be in the form of drug abuse, antipsychotic drugs or eating disorders like binge eating, stress eating, where you put on a lot of fat in the body or malnutrition where you are avoiding to eat. Stress can be due to excessive exercise. People have a lot of craving to zero size. Doing exercise that your body is not used to, excessive vigorous exercise, where you are losing a lot of body fat or putting on a lot of weight, where you have sedentary lifestyle, excessive weight gain. All these are related to a hypothalamus abnormality, where the GnRH hormone is reduced and because of this there is either stimulation or depression of these hormones which leads to irregular cycles"

"The tests we do for irregular periods depends on the cause of irregular periods. The causes can be from the brain that is the hypothalamopituitary axis, or in the ovaries or the uterus. Our investigations depends on where can be the pathology. So a simple history taking will help us diagnose. So a good menstrual history is very important. Second we may just do an examination, just to look if the area is very normal, with a hymen or if there is an infection. Third is we do the blood test, that is we do hormonal tests to see if the menstrual flow is good. So we do a few array of hormonal test. To name them they are the follicular stimulating hormone luteinizing hormone, estrogen, progesterone and most important is the thyroid and the prolactin. So if there is any variation in that, if it is a thyroid we can address the issue. If it is a pituitary gland, then we do a little bit of investigation. If the hormone levels are normal, we do the next level of abdominal scans. There are two types of abdominal scans that is transabdominal or transvaginal. Most of the times the radiologist will ask for a transvaginal scan because most of the organs could be probably seen in a better view doing a transvaginal scan. If you are not comfortable and if you feel there are tumors in the ovary, we would what a transabdominal scan as well. This will tell us the ovarian and uterine cause. Tuberculosis of the uterus is some condition were we would want to do a diagnostic D&C and test for TB of the uterus also if it becomes beyond this stage where it shows normal in the uterus , ovaries or the hormonal assay we may have to go upto the brain tissues where we have to do MRI of the brain called as prolactinomas and a CT scan. Even some of the investigation like knowing the karyotyping of a woman may be required"