polymenorrhea

{{Short description|More frequent menstruation}}

{{Infobox medical condition (new)

| name = Polymenorrhea

| synonyms = Polymenorrhoea; Polymenorrhœa; Frequent periods; Frequent menstrual bleeding; Frequent menstruation; Epimenorrhea; Epimenorrhoea; Epimenorrhœa; Abnormally frequent menstruation; Unusually frequent menses

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| field = Gynecology

| symptoms = Short menstrual cycles (<21{{nbsp}}days) that are otherwise regular and normal

| complications = Anemia; Iron deficiency; Endometrial cancer (when related to inadequate luteal phase)

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| duration =

| types =

| causes = Anovulation; Inadequate/short luteal phase; Short follicular phase; Certain endocrine disorders; Puberty/adolescence; Perimenopause

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| diagnosis =

| differential = Metrorrhagia (intermenstrual bleeding)

| prevention =

| treatment = Hormonal agents

| medication = Progestogen during luteal phase; Combined oral contraceptive pill

| prognosis = Usually transient and self-limited

| frequency =

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Polymenorrhea, also known as frequent periods, frequent menstruation, or frequent menstrual bleeding, is a menstrual disorder in which menstrual cycles are shorter than 21{{nbsp}}days in length and hence where menstruation occurs more frequently than usual.{{cite journal | vauthors = Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K, Dungan K, Hershman JM, Hofland J, Kalra S, Kaltsas G, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, Levy M, McGee EA, McLachlan R, Morley JE, New M, Purnell J, Sahay R, Singer F, Sperling MA, Stratakis CA, Trence DL, Wilson DP, Reed BG, Carr BR | title = The Normal Menstrual Cycle and the Control of Ovulation | journal = Endotext | volume = | issue = | pages = | date = 5 August 2018 | pmid = 25905282 | doi = | url = https://www.ncbi.nlm.nih.gov/books/NBK279054/}}{{cite book | author1 = Tamara Callahan | author2 = Aaron B. Caughey | date = 28 January 2013 | title = Blueprints Obstetrics and Gynecology | publisher = Lippincott Williams & Wilkins | pages = 296– | isbn = 978-1-4511-1702-8 | oclc = 1023316161 | url = https://books.google.com/books?id=eKC1B3BhlxUC&pg=PA296}} Cycles are regular and menstrual flow is normal in the condition. Normally, menstrual cycles are 25 to 30{{nbsp}}days in length, with a median duration of 28{{nbsp}}days.

Polymenorrhea is usually caused by anovulation (failure to ovulate), an inadequate or short luteal phase, and/or a short follicular phase.{{cite journal | vauthors = Oriel KA, Schrager S | title = Abnormal uterine bleeding | journal = Am Fam Physician | volume = 60 | issue = 5 | pages = 1371–80; discussion 1381–2 | date = October 1999 | pmid = 10524483 | doi = | url = https://www.aafp.org/pubs/afp/issues/1999/1001/p1371.html}} Polymenorrhea is common in puberty and adolescence due to the immaturity of the hypothalamic–pituitary–gonadal axis (HPG axis). Shorter menstrual cycles are also common in the early perimenopause (menopausal transition), during which time the lengths of menstrual cycles may be reduced by 3 to 7{{nbsp}}days secondary to a shorter follicular phase.{{cite journal | vauthors = Goldstein SR | title = Menorrhagia and abnormal bleeding before the menopause | journal = Best Pract Res Clin Obstet Gynaecol | volume = 18 | issue = 1 | pages = 59–69 | date = February 2004 | pmid = 15123058 | doi = 10.1016/j.bpobgyn.2003.10.003 | url = }}{{cite book | vauthors = Prior JC | title = Endocrine Facets of Ageing | chapter = The ageing female reproductive axis II: Ovulatory changes with perimenopause | journal = | series = Novartis Foundation Symposia | volume = 242 | issue = | pages = 172–86; discussion 186–92 | date = 2002 | pmid = 11855687 | doi = 10.1002/0470846542.ch11| isbn = 9780471486367 | chapter-url = }} Certain endocrine disorders, such as hyperprolactinemia, hypothyroidism, hyperthyroidism, Cushing's syndrome, and acromegaly, can cause polymenorrhea.{{cite journal | last1 = Unuane | first1 = David | last2 = Tournaye | first2 = Herman | last3 = Velkeniers | first3 = Brigitte | last4 = Poppe | first4 = Kris | title = Endocrine disorders & female infertility | journal = Best Practice & Research Clinical Endocrinology & Metabolism | date = December 2011 | volume = 25 | issue = 6 | pages = 861–873 | issn = 1521-690X | doi = 10.1016/j.beem.2011.08.001 | pmid = 22115162 | url = }}{{cite journal | last1 = Kalro | first1 = Brinda N | title = Impaired fertility caused by endocrine dysfunction in women | journal = Endocrinology and Metabolism Clinics of North America | date = September 2003 | volume = 32 | issue = 3 | pages = 573–592 | issn = 0889-8529 | doi = 10.1016/S0889-8529(03)00041-0 | pmid = 14575026| url = }}{{Additional citation needed|date=July 2022}} While not a classical symptom, polymenorrhea can occur as a result of uterine fibroids.{{cite book | author = Swaraj Batra | date = 2011 | title = Case Discussions in Obstetrics and Gynecology | publisher = Jaypee Brothers Medical Publishers Pvt. Ltd. | pages = 231– | isbn = 9789350258484 | oclc = 856017557 | url = https://books.google.com/books?id=C7-oNfjSDBEC&pg=PA231}} Polymenorrhea may result in anemia and iron deficiency due to blood loss. In addition, when it is due to an inadequate luteal phase and hence progesterone deficiency, polymenorrhea may be related to an increased risk of endometrial cancer.{{cite journal | vauthors = Schindler AE | title = Progestogen deficiency and endometrial cancer risk | journal = Maturitas | volume = 62 | issue = 4 | pages = 334–7 | date = April 2009 | pmid = 19231117 | doi = 10.1016/j.maturitas.2008.12.018 | url = }}

Polymenorrhea is usually transient and self-limited, thereby not necessitating treatment.{{cite journal | vauthors = Tscherne G | title = Menstrual irregularities. Evidence-based clinical practice | journal = Endocr Dev | volume = 7 | issue = | pages = 129–39 | date = 2004 | pmid = 15045790 | doi = 10.1159/000077081 | url = }} If it persists, is disturbing, or if there is considerable blood loss due to the frequent periods, treatment may be indicated. The mainstays of treatment are a progestogen during the luteal phase of the cycle or a combined oral contraceptive pill.

Polymenorrhea is sometimes confused with metrorrhagia (menstrual bleeding between periods). It can be distinguished from metrorrhagia by its regularity. Polymenorrhea can be contrasted with oligomenorrhea, in which menstrual cycles are greater than 35 or 37{{nbsp}}days in length.{{cite book | vauthors = Walker HK, Hall WD, Hurst JW, Long WN | title = Abnormal Vaginal Bleeding | year = 1990 | volume = | pages = | publisher = Butterworths | pmid = 21250125 | doi = | isbn = 9780409900774 | url = https://www.ncbi.nlm.nih.gov/books/NBK282/}} The condition can also be distinguished from polymenorrhagia, which is a combination of polymenorrhea and menorrhagia (heavy menstrual bleeding).{{cite journal | vauthors = Woolcock JG, Critchley HO, Munro MG, Broder MS, Fraser IS | title = Review of the confusion in current and historical terminology and definitions for disturbances of menstrual bleeding | journal = Fertil Steril | volume = 90 | issue = 6 | pages = 2269–80 | date = December 2008 | pmid = 18258230 | doi = 10.1016/j.fertnstert.2007.10.060 | url = | doi-access = free }}