If you are only having menses once a year, this is highly unusual and I would highly suggest that you see a gynaecologist for evaluation.
Normal cycle length usually ranges between 24 to 38 days - that is, most women would have a menstrual bleed a month.
While some women do have a longer cycle length of say 45 to even 60 days, a history of having menses only 2-3 times a year would immediately alert the gynaecologist to look for the possibility of polycystic ovarian syndrome.
This is a condition whereby the eggs of the ovary do not develop to maturity enough to ovulate, hence there are many eggs that are "arrested" in mid phase.
These eggs continue to produce the female hormone estrogen, which stimulate and thicken the womb lining, but yet there is no ovulation to trigger the second half of the menstrual cycle to result in menses (shedding of the womb lining).
This is a cause for concern because the continued stimulation of the womb lining (due to unopposed estrogen) can cause womb lining thickening that can increase the risk for cancer of the womb lining in the future.
Polycystic ovarian syndrome is also associated with other risks such as obesity, hypertension, and diabetes mellitus.
Of course if ovulation only occurs sporadically, this can affect the chances of getting pregnant.
I would advise you NOT to delay in seeking a gynaecological evaluation.
Best regards
Dr Fong Yoke Fai
