The uterine lining (endometrium) prepares for a baby with each menstrual cycle. If fertilization does not occur, the body sheds the endometrium during the cycle. Even though menstrual periods are not the same for every woman, extremely heavy periods, periods that last too long, skip several months in a row, or are persistently unpredictable are considered abnormal.
OB/GYN Lillian Schapiro, MD, FACOG, of Ideal Gynecology in Atlanta, Georgia, wants patients to feel comfortable discussing potential issues with their periods. There’s certainly no one-size-fits-all rule to periods, but there are instances where you should see a doctor.
A late or missed period here or there is rarely anything to worry about. However, persistently irregular periods may signal that something more is going on. Here’s how to tell if you should be concerned and when to see a healthcare provider about it.
What is considered an irregular period?
For women, a typical cycle can last anywhere between 21-35 days. Although a 28-day cycle is considered typical, there is room for variation. Tracking your cycle is one of the best ways to detect patterns and determine if something’s amiss.
Count from the last day of your last period to the first day of your next to see if your menstrual cycle is irregular. It’s best to track your cycle for at least three consecutive months. You have an irregular cycle if it deviates too far outside of the 21-35 day window, if you often skip periods or if there is a wide variation month-to-month.
Causes of irregular periods
Your menstrual cycle's length and frequency can change depending on a variety of factors. Take a look at some of the most common causes of irregular periods:
Polycystic ovary syndrome occurs when the ovaries produce excess "male" hormones (androgens). Nearly 90% of women with PCOS experience irregular menstrual cycles.
Issues with the thyroid, such as hypothyroidism and hyperthyroidism, as well as problems with the pituitary gland can cause irregular menstrual cycles. Endocrine glands are responsible for secreting your body’s hormones. The pituitary gland directs the endocrine organs. Problems with any part of this system can lead to menstrual irregularities.
Pelvic inflammatory disease
Pelvic inflammatory disease is a common cause of irregular periods. It occurs when there is inflammation of the upper reproductive system and is typically brought on by STDs.
When to see a healthcare provider
If your cycle has changed, it’s wise to consult with a gynecologist. For instance, if you are unexpectedly skipping several months or bleeding nonstop for three weeks, it may be a sign of a more serious condition.
An irregular period isn't always cause for concern, but you should consult a gynecologist if your menstrual cycle changes in any unusual ways. Sometimes stress, birth control, or weight changes are behind irregular periods, but it’s best to have a gynecologist evaluate the situation.
Here’s what to look out for:
- Periods that are routinely fewer than 24 days apart
- Periods that last more than seven days
- Painful periods
- Consistently skipping a period by two months
- Regularly bleeding in between periods
- Recurring instances of heavy bleeding
Women who bleed excessively are at risk for low red blood (anemia), which can cause fatigue and fainting.
If you've noticed changes in your period, your provider may recommend taking a thyroid test. There are treatments for irregular periods, such as oral contraceptives, contraceptive patches, contraceptive vaginal rings, oral progesterone, and IUDs that contain progesterone.
There are also surgical procedures like endometrial ablation if you're looking for a long-term solution.
If you’re having irregular periods, stop in to see us, and we’ll help you figure out what’s going on. A knowledgeable Ideal Gynecology team is waiting to assist you in scheduling a visit with Dr. Schapiro today.