Irregular periods. A lot of us have experienced them and don’t understand WHY our period can’t just come at the same time every month! I get a lot of questions about irregular periods; why it happens, if it’s a bad thing, what it means, should you go to a doctor, etc. I wish I could give you a direct answer, but since everyone’s body is different, it’s not that black and white! For today’s post, I’m giving you a short, easily digestible explanation of what the deal is with irregular periods and what they mean. If you want a further deep dive, check out my IG Live where I draw and explain the menstrual cycle for you guys and answer all of your questions! Now, let’s get into it!
I want you to think of your period as a vital sign.
The normal length of a menstrual cycle is 21-35 days, with 7 of those days being when bleeding occurs. Totally normal! What you need to watch for is any abnormal bleeding.
What is abnormal bleeding?
- Bleeding spotting in between periods
- Bleeding spotting after sex
- Heavy bleeding during periods: soaking through one or more tampons/pads every hour; more than 7 days
- Not having a regular cycle of 21-35 days
- Irregular periods, cycle length varies by more than 7 to 9 days
- Not having a period for 3-6 months
- Bleeding after menopause
Abnormal bleeding is more common in certain age groups. Typically ages 9-14 when we first start, or during perimenopause around 45-50. This is when it is common to skip periods or have heavier periods.
Causes
There are many different causes of abnormal bleeding, but here are the most common:
- Problems with ovulation: If you don’t ovulate every month, the endometrium (the lining of the uterus) can begin to thicken over time and there is no monthly shedding of this lining (like what we see with a normal period!)
- PCOS: Polycystic ovary syndrome is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs
- Hypothyroidism: A common condition where the thyroid doesn’t create and release enough thyroid hormone into your bloodstream
- Fibroids or Polyps
- Adenomyosis: where the endometrium (remember: the lining of the uterus!) grows into wall of the uterus.
- Bleeding disorders
- Medications: Such as birth control, IUDs, and blood thinners
- Cancer (endometrial)
- Others like endometriosis, ectopic pregnancy, or a miscarriage
- PID: Pelvic inflammatory disease is an infection of the female reproductive system which includes the womb, fallopian tubes, and ovaries
What to Do
If you’re experiencing abnormal bleeding and feeling concerned, talk to your OBGYN. It’s also a great idea to track your periods and note the quality and quantity of bleeding. Your OBGYN can also run tests including a full history and physical exam, pelvic exam, ultrasounds, blood work, STI panels, etc!
Solutions: this will all depend on the reason you are having irregular periods! Make sure to talk to your doctor directly. Depending on the diagnosis we can use things like:
- GnRH agonists
- TXA
- NSAIDs
- Antibiotics if there is an infection
- Birth control (pills, IUD, injection, vaginal ring, etc!)
- Surgery: ablation, fibroid (myomectomy), UAE, hysterectomy
For more questions on irregular periods, make sure to follow me on Tiktok where I share information on your menstrual cycle!
