Why do I have irregular periods?

Q: I am a 23 years old unmarried woman who has been diagnosed with ovarian cysts with irregular periods for the last 5 years. I have consulted four doctors and they all said that it is usual and can be cured with tablets; also it will be alright after I get married. So, they advised me to get married soon. But I am still suffering from this problem and I had periods for this entire month. Since I could not tolerate the pain I took Primolid to stop the periods. Later it started to clot and the flow was heavy. Since I am working I am unable to manage with this irregular periods. Will it affect my chances of conceiving after marriage? Is it true that this problem gets solved after marriage? Please advise.

A:Very rarely does an ovarian cyst cause any menstrual / bleeding problem. In your case it certainly does not look like the ovarian cyst (s) is the underlying problem for your bleeding.

There are no ovarian cysts, which disappear (get better) after marriage! By marriage I assume the doctor is hinting towards the fact that sexual activity will have influence on the cysts.

If I get your story correctly, you have painful, heavy and irregular periods. One of the conditions I can think of which is fairly common in younger age group as yours is endometriosis. This is a condition commonly associated with painful periods and can vary in severity from mild disease to severe forms. It is not possible to go into greater details of this condition in this mail. This can also be associated with ovarian cysts called endometrioma. It is possible to diagnose these ovarian cysts with reasonable confidence by an experienced ultrasonographer.

Endometriosis does not by itself give irregular periods. Irregular periods are more likely to be because of hormonal imbalance due to various factors. The best thing for you at the moment is to take combined oral contraceptive pills. These pills should regularise your cycles, reduce the blood flow and the pain during periods. You may take three packets back to back i.e. without taking a break after every month. In addition you can also take painkillers to control pain. See how you feel. If symptoms persist - you may need laparoscopy (keyhole operation) to see if there is any obvious cause of painful periods. I would not suggest you hysteroscopy (telescopic check of your womb) at this stage.

Without having more information on your diagnosis, unfortunately it is not possible for me to make any further comments especially on your chances of conceiving (pregnancy).

I think you should see some other gynaecologist who will give you a medical diagnosis and treatment - something more than offering advice to 'get married soon'!