Can sleep disturbance and irregular period affect fertility?

Question

Hello doctor,

I am 28 years old and have not been sleeping well for almost three months, especially around the time of my menstrual cycle. Most nights, I lie awake until 4 a.m. and feel very tired during the day at work. My periods have also become irregular; sometimes they come every 35 days, and other times every 21 days. I have tried taking Melatonin, but it does not help much anymore. My partner and I are trying to conceive, so I am worried if this could affect my fertility.

Could my sleep problems be related to hormonal changes that are also affecting my menstrual cycle?
Should I be concerned about the long-term effects on my reproductive health if this continues?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

According to the FIGO (International Federation of Gynecology and Obstetrics) classification, heavy menstrual bleeding can be assessed based on cycle frequency, duration, regularity, and volume of flow. In terms of frequency, absent bleeding is referred to as amenorrhea.

Frequent bleeding occurs when the cycle is less than 24 days; normal cycles range between 24 and 38 days; and infrequent bleeding occurs when the cycle exceeds 38 days. The normal duration of bleeding is up to eight days, while prolonged bleeding lasts more than eight days. Regular cycles show a variation of less than nine days between the shortest and longest cycles, whereas irregular cycles show a difference of more than 10 days. Flow volume can be classified as light, normal, or heavy.

Based on your history, it appears that your menstrual cycle is irregular, which may affect your fertility when trying to conceive. I recommend some blood tests to better understand the underlying cause. These include follicle-stimulating hormone (FSH) and luteinizing hormone (LH) on the second day of your period, thyroid-stimulating hormone (TSH), free thyroxine (free T4), free triiodothyronine (free T3), and prolactin levels.

For management, you should consult a psychiatrist to address your ongoing sleep difficulties (insomnia). Additionally, you may start Dydrogesterone tablets, 10 milligrams, by taking one tablet twice daily starting from the second day of your period. Continue for 21 days, followed by a seven-day break, and repeat this for three months. You should also take Folic Acid tablets, 5 milligrams, once daily for three months. After finishing the Dydrogesterone tablets each month, begin taking one sachet at night of Myo-Inositol and D-Chiro-Inositol powder (Myo-Inositol + D-Chiro-Inositol) and continue this daily for three months.

I hope you are satisfied with my answer.

For further queries, you can consult me at iCliniq.