How to track pregnancy with irregular periods

With irregular menstrual cycles, it may become difficult for you when you miss a period, to say if you are actually pregnant or if its just those highly unpredictable and haphazhard cycles. Through this article I will bring to you few tips on early detection of pregnancy.

I will also take you through points to pay special attention to while doing pregnancy tests if you have unpredictable cycles. You will find answers to doubts like how many days to confirm pregnancy for irregular periods?

Before details on irregular cycles and the challenges associated with detecting pregnancy in women with irregular cycles let us try to understand a normal menstrual cycle.

The menstrual cycle:

A normal menstrual cycle is divided into two parts which are demarcated by the day of ovulation. The first day of your period or menstrual flow is considered as the first day of your menstrual cycle. So, the first part of the menstrual cycle will comprise of the days during which you experience menstrual flow and extend upto the day of ovulation. During the first part of a woman’s menstrual cycle the uterine lining is shed off due to withdrawal or low levels of the hormone progesterone and then it begins to regrow in thickness under the influence of the reproductive hormone namely estrogen.

The second part of the menstrual cycle is marked by the day of ovulation. After ovulation, the uterine lining starts secreting thin fluid in preparation to implant an embryo if fertilization happens. So the time around ovulation is considered to be the most fertile period of a woman’s menstrual cycle, though pregnancy may happen anytime. After few days of ovulation, if fertilization of the egg released during the cycle does not take place, the levels of the hormone progesterone start falling.

The duration of the first part of the menstrual cycle is variable and depends on the total length of a woman’s menstrual cycle, whereas the second part is fairly constant and lasts roughly for about 13-15 days from the day of ovulation. In a woman with a 28 days cycle, ovulation roughly falls on the 14th day of the cycle; whereas in a woman with 30 days cycle the ovulation happens around 16th day of the cycle.

Now we get an idea that fertilization of the ovum leading to pregnancy in a woman usually happens about 14-15 days before the expected date of the woman’s period. But what about women with irregular periods? How do we predict the possible time of pregnancy when unsure about the date of a woman’s next period?

Irregular periods

What are irregular periods?

Irregular periods are when the gap between the start of your periods keep changing, though it is not unusual for it to vary by a few days each time.On an average the menstrual cycle lasts for 28 days.In women with irregular menstrual cycles, each cycle may vary between 21 to 35 days.A woman with irregular cycles may get her periods early or late each time and may remain unsure of the expected date of her next period.

Causes of irregular periods:

Sometimes irregular menstrual cycles may just be normal for a woman and may depend on her hormone cycles. Below are few factors which may cause irregularities in a woman’s menstrual cycle:

• Puberty –periods may remain irregular for the first one or two years of attaining menarche which is onset of the first menstrual bleeding in a girl.
• Periods may get irregular around the start of menopause usually between 45-55years of age
• Physical stress such as extreme exercising may cause hormonal disturbances leading to irregular cycles.
• Emotional stress also may cause irregular periods
• Extreme weight gain or weight loss may also trigger hormonal imbalance and irregular periods
• Some hormonal contraceptives such as oral contraceptive pills and intrauterine devices may also alter your menstrual cycles.
• Thyroid disorders like hypothyroidism where a womans thyroid hormone levels may be inadequate.
• Polycystic ovarian syndrome where women have an imbalance of sex hormones and anovulatory cycles leading to irregular periods

When do you need to seek medical help for irregular periods?

• If you are under the age of 45 and have had regular periods till date and it suddenly becomes irregular,you may need to get an opinion from your gynaecologist.
• If your periods occur more frequently than every 21 days or less often than every 35 days.
• If you have prolonged periods lasting for more than 7 days.
• If the difference between your shortest and longest menstrual cycle is 20 or more days
• If your having difficulty in getting pregnant

How to get pregnant with irregular periods?

Women having difficulty in getting pregnant associated with irregular periods is most often due to anovulation.Anovulation is the failure to release an ovum from the ovary during the menstrual cycle. Menstruation happens when the progesterone released from the ovary after ovulation is withdrawn.Progesterone is withdrawn if there is no fertilization of the ovum by a sperm resulting in pregnancy.So,failure to ovulate means the events leading to menstruation also do not occur.

Sometimes even in the absence of ovulation menstrual bleeding which may be scanty may happen which is termed anovulatory bleeding.As it may be irregular it is called breakthrough bleeding.
Anovulation may be as a result of hormonal imbalances produced by underlying factors such as thyroid disorders, polycystic ovarian syndrome,obesity,stress etc.
Battery of tests which may be required to detect the cause for infertility and irregular periods are:

Hormonal tests:

• Thyroid function tests
• Serum prolactin level
• Testosterone level
• Serum HCG level
• Cortisol level
• Insulin level
• LH and FSH levels
• GnRH levels

Once the hormonal balance has been restored ,ovulation resumes and pregnancy can happen.What are the ways to achieve hormonal balance and successful ovulation?

• Most women can conceive spontaneously just by losing weight.
• Moderate exercise on a regular basis will help you lose weight steadily.Exercise also helps alleviate stress which may be the sole cause for irregular menstrual cycles.
• If your cycles persist to be anovulatory and fail to conceive despite weight loss, your doctor may prescribe you medicines to stimulate ovulations so as to get you pregnant.The medicines modify hormone levels in the woman so as to get them to ovulate successfully.Clomiphene citrate is usually the first choice as an ovulation inducing agent.
• If clomiphene citrate fails to induce ovulation in a woman,the next line of treatment would be gonadotrophin injections.They are used for more aggressive form of treatment.Gonadotrophins act by stimulating growth of a dominant follicle to result in ovulation.In comparison to clomiphene citrate gonadotrophins are associated with higher risk of multiple pregnancy and hyperstimulation of the ovaries.

If you have been maintaining a menstrual calendar so as to predict the most fertile period or the safe period of your menstrual cycle, it may be a mind-boggling task to do if you have very irregular cycles.You may not be able to predict the time of your subsequent ovulation and date of start of the next period.

How to Calculate the Time of Ovulation?

• Suppose a woman has a cycle length of 30 days, the ovulation period roughly falls in the mid 10 days.
• So, to avoid pregnancy she has to better avoid unprotected sexual intercourse in this period.
• The rest of the days i.e., starting from menstruation to the 10th day and again from 21st day up to menstruation are the safe days or the safe period to avoid pregnancy.

What is Safe Period?

It is the period when supposedly a woman has the least chance of getting pregnant.

What is the Unsafe Period?

A woman conceives if she copulates within the time of ovulation.

Hence the time of ovulation is termed as the unsafe period to have sexual intercourse.

By no means, it provides a complete protection against pregnancy, since it has been seen that the intercourse itself may trigger untimely ovulation.

But please keep in mind that, this calculation is for a woman with a fairly constant menstrual cycle:

• If you have irregular periods and are totally relying on the safe period method of contraception you may land up in an unplanned pregnancy.
• If you have been trying to get pregnant with irregular menstrual cycles, you may not be able to successfully time sexual intercourse to your ovulation and it would be wiser to try frequent intercourse during your cycle.

Now after elaborate information on a woman’s menstrual cycle and fertile period, let us look into a missed period associated with pregnancy.

How to tell if your pregnant?

A missed period is the first sign of pregnancy in most women. Here are few simple and accessible ways to confirm a pregnancy:

Urine Pregnancy Test:

Urine pregnancy tests or home pregnancy test kits can detect pregnancy in the week after missed period.It can be taken in the privacy of your home or even at the clinic.It detects the hormone human chorionic gonadotrophin(hCG) in the urine. The hormone is made right after a fertilized egg attaches to the wall of a woman’s uterus or outside. This usually happens about 6 days after fertilization. If you’re pregnant, levels of hCG continue to rise rapidly, doubling every 2 to 3 days. Home urine pregnancy test kits come with instructions. Follow them closely for the most accurate results. After testing, you can confirm results by consulting your doctor, who can perform even more sensitive pregnancy tests.

Blood Test:

The blood test for pregnancy detects the human chorionic gonadotrophin in the blood. These tests can detect pregnancy earlier than a urine pregnancy test, or about 6 to 8 days after ovulation. But with these tests, it takes longer to get the results than with a urine pregnancy test.

Two types of blood pregnancy tests are available:

A qualitative hCG test simply checks to see if hCG is present only to tell if your pregnant or not.

A quantitative hCG test (beta hCG) measures the exact amount of hCG in your blood. It can find even very low levels of hCG. Because these pregnancy tests can measure the concentration of hCG, they may be helpful in tracking any problems during pregnancy.

The details on initial pregnancy testing have answered the question how early can pregnancy be tested for? A blood test can detect pregnancy as early one week before a missed period and home urine pregnancy test can detect pregnancy about a week after a missed period.

Whether it will be as simple in case of a woman with irregular periods is the question which may be bothering many. With highly unpredictable cycles it is very difficult for a woman to actually tell if she has missed a period owing to pregnancy or whether it’s just that her periods are coming late.

How to go about testing for pregnancy if you have irregular menstrual cycles?

You may want to wait for about 35 days from the start of your previous period or a week past the longest cycle before you think of the possibility of pregnancy. If you test negative for pregnancy by a home urine pregnancy test, you may repeat the test after few days or at a weeks interval. If you are too anxious to wait, you may want to get a pregnancy detection blood test done at your doctor’s clinic for earlier detection of pregnancy. The blood test reports may take a few days though.

If your periods fail to come you should repeat the urine or blood tests for pregnancy after a weeks interval.

Now coming to how many days to confirm pregnancy for irregular periods?

It may vary anywhere between 42-49 days from the start of your last period considering your longest cycle to be of 35 days duration. To confirm pregnancy for irregular periods a woman should get tested about a week or two past her longest cycle till date. However, pregnancy may happen as early as 7th day of a very short cycle of about 21 days and may be detectable much earlier than a month past the start of the previous period.

Confirmation of pregnancy:

The confirmation of pregnancy can be done by your doctor based on urine and blood tests. Further confirmation of a live pregnancy within the uterus can be done by your doctor with the help of ultrasonography. Ultrasonography done early in pregnancy can also help the doctor detect the duration of pregnancy.

Hope this article has cleared your mind of all concerns regarding irregular periods and pregnancy. Through this article, I have also brought to you the answer to how many days to confirm pregnancy for irregular periods?

How can you tell if your pregnant if you have irregular periods?

Do pregnancy tests work if you have irregular periods?