Problems with the menstrual cycle, the process that prepares the female body for pregnancy, can lead to infertility. The menstrual cycle includes several phases, and problems at any one of the stages can lead to difficulty getting pregnant or to infertility.
For most women, a normal menstrual cycle ranges from 21 to 35 days. However, 14% to 25% of women have irregular menstrual cycles, meaning the cycles are shorter or longer than normal; are heavier or lighter than normal; or are experienced with other problems, like abdominal cramps. Irregular cycles can be ovulatory, meaning that ovulation occurs, or anovulatory, meaning ovulation does not occur.
The most common menstrual irregularities include:
Amenorrhea (pronounced ey-men-uh-REE-uh) or absent menstrual periods: When a woman does not get her period by age 16, or when she stops getting her period for at least 3 months and is not pregnant.
- Oligomenorrhea or infrequent menstrual periods: Periods that occur more than 35 days apart
- Menorrhagia or heavy menstrual periods: Also called excessive bleeding. Although anovulatory bleeding and menorrhagia are sometimes grouped together, they do not have the same cause and require different diagnostic testing.
- Prolonged menstrual bleeding: Bleeding that exceeds 8 days in duration on a regular basis.
- Dysmenorrhea: Painful periods that may include severe menstrual cramps.
Additional menstrual irregularities include:
- Polymenorrhea: Frequent menstrual periods occurring less than 21 days apart
- Irregular menstrual periods with a cycle-to-cycle variation of more than 20 days
- Shortened menstrual bleeding of less than 2 days in duration
- Intermenstrual bleeding: Episodes of bleeding that occur between periods, also known as spotting
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