Your menstrual cycle can vary from 22 to 35 days with normal menstrual flow lasting from three to seven days. What if your flow, or cycle frequency is different? Here's what you need to know about menstrual cycle dysfunction.

Up to 30 percent of women of reproductive age have menstrual irregularities for which they seek medical attention. According to the Cleveland Clinic, these irregularities may be caused by:

  • Anatomical reasons (for example, fibroids or endometriosis)
  • Blood-related conditions (anemia, leukemia)
  • Systemic disease (anorexia, obesity)
  • Endocrine problems
  • Medications, such as steroids

Additionally, menstrual irregularities may be influenced by existing mental health conditions and smoking, obesity, or other lifestyle choices.

Menstrual Cycle Dysfunction That Affects the Cycle Frequency

Some menstrual cycle dysfunction affects the actual monthly cycle, from frequency to flow. They include:

Oligomenorrhea: too few cycles

Amenorrhea: delayed or missing cycles

Dysmenorrhea: painful cramps and heavy menstrual flow

Girls and women who participate in intensive sports training—particularly sports that emphasize being lean, such as running—may experience disruptions in their menstrual cycles, delaying the start of periods, or causing women with established cycles to miss consecutive periods.

The American College of Sports Medicine says there is no single cause of exercise-associated amenorrhea, but low body weight, low body fat percent, and nutritional shortfalls may all contribute. Women with exercise-associated amenorrhea are at risk for bone density loss due to estrogen deficiency, which affects the body's ability to absorb calcium.

If you experience any of these irregularities, seek a medical evaluation.

Menstrual Cycle Dysfunction That Affects Mind and Body

Women with regular cycles may experience changes to their body (and mood) at certain times during their cycle. They are common, and most women are familiar with them:

Premenstrual Syndrome (PMS): Symptoms include irritability and anxiousness before menstrual period begins. Women may also struggle with mood changes, acne, breast tenderness, fatigue, bloating, constipation or diarrhea, head or backaches, and food cravings.

Premenstrual Dysphoric Disorder (PMDD): When PMS becomes severe, physicians call it PMDD. Some women experience clinical levels of depression or anxiety during the one to two weeks before each menstrual cycle, although symptoms resolve once their period begins.

An estimated 40 percent of women who seek treatment for PMDD actually have an underlying mood disorder, which PMS exacerbates. During premenstrual cycles, women with PMDD experience changes in the brain, which affect areas that control emotions.

Prevention and Treatment of PMS and PMDD

Functional physician Mark Hyman, MD, believes PMS and PMDD are caused by bad habits, environmental toxins, and stress, and that conventional treatments, such as anti-inflammatory drugs, birth control pills, prescription medications, or diuretics, are based on a faulty assumption. He says, "To think that 75 percent of women have a design flaw that requires medical treatment to live a normal life is just absurd."

Instead, Hyman suggests the following to combat the symptoms:

  • Clean up your diet (avoiding sugar, caffeine, alcohol)
  • Eat evenly throughout the day
  • Increase fiber from healthy sources
  • Consume sufficient omega-3 fatty acids
  • Engage in regular physical exercise
  • Employ stress-reduction techniques

Liesa Harte, MD, reviewed this article.



Lebrun, Constance M., M.D., FACSM." Menstrual Cycle Dysfunction."

American College of Sports Medicine. Web.

Bradley, Linda. "Menstrual Dysfunction." Cleveland Clinic. Web.

Pinkerton, JoAnn V., MD. "The Menstrual Cycle-Mood Disorder Tandem: Screening, Diagnosis, and Treatment." OBManagement 23(12) (2011). Web.

Dušek, Tina. "Influence of High Intensity Training on Menstrual Cycle Disorders in Athletes."
Croatian Medical Journal 42(1) (2001: 79-82.


UNC School of Medicine. Department of Psychiatry. Center for Women's Mood Disorders. "Menstrually Related Mood Disorders." Web.

Hyman, Mark, MD. "How to Eliminate PMS in 5 Simple Steps." Blog. Web. 17 September 2010.