From the Guidelines
Having a menstrual cycle every 2 months is not considered a normal menstrual pattern for most women, and it is essential to consult a healthcare provider to rule out any underlying health conditions. A typical menstrual cycle ranges from 21 to 35 days, with the average being about 28 days. If you're consistently experiencing periods only every two months, this is considered oligomenorrhea, or infrequent menstruation. This pattern could be caused by various factors, including hormonal imbalances, polycystic ovary syndrome (PCOS), thyroid disorders, extreme weight changes, excessive exercise, stress, or certain medications 1.
Some possible causes of oligomenorrhea include:
- Hormonal imbalances, such as those caused by polycystic ovary syndrome (PCOS) 1
- Thyroid disorders, such as hypothyroidism or hyperthyroidism
- Extreme weight changes, either gain or loss
- Excessive exercise, which can disrupt hormone levels
- Stress, which can affect hormone production
- Certain medications, such as those used to treat epilepsy or other conditions
It's crucial to consult with a healthcare provider if you're experiencing this pattern, especially if it's a change from your normal cycle. They may recommend blood tests to check hormone levels, such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH) 1, or an ultrasound to examine your reproductive organs. While some variation in cycle length is normal, consistently having periods only every two months may affect fertility and could indicate an underlying health condition that needs attention 1.
In terms of management, medical treatments for abnormal uterine bleeding associated with ovulatory dysfunction include progestin-only contraception and combined hormonal contraception 1. If medical treatment fails, is contraindicated, or is not tolerated, or if the patient has concomitant significant intracavitary lesions, surgery, including endometrial ablation and hysterectomy, may be an option 1. Additionally, lifestyle modifications, such as maintaining a healthy weight, engaging in regular exercise, and managing stress, may also help regulate menstrual cycles 1.
From the Research
Menstrual Cycle Frequency
- A normal menstrual cycle typically occurs every 21-35 days, with an average duration of 28 days 2.
- Having a menstrual cycle every 2 months may be considered irregular, as it falls outside of the typical range.
Factors Influencing Menstrual Cycle Length
- Hormonal imbalances, such as those experienced by women with polycystic ovary syndrome (PCOS), can lead to irregular menstrual cycles, including longer cycles 3.
- Women with PCOS who are resistant to clomiphene citrate (CC) may experience significantly longer menstrual cycles compared to those who are CC-sensitive 3.
Ovulation and Menstrual Cycle Regulation
- The hypothalamus, pituitary, ovary, and endometrium work together to regulate the menstrual cycle, with the hypothalamus setting the pace through the pulsatile release of gonadotropin-releasing hormone (GnRH) 2.
- The integrated action of these components leads to ovulation, which is triggered by a surge in luteinizing hormone (LH) secretion 2.