Irregular periods are a concern for many and can happen at all stages of life. Periods can show up early or come late, and the gaps between periods can vary. There can also be differences in flow – heavy, light, short, or long periods – as well as many other variations.
Irregular periods do not automatically mean there is something wrong with you. Irregular periods are also expected during the first several years after your first period starts and during the time leading up to menopause. In some cases, variations in periods can be caused by factors such as weight changes, stress, certain medications, or pregnancy, but they can also be caused by health problems. Learning more about what can cause irregular periods can help you decide if you should see a doctor. This guide can show you more about common causes, other things to look for, ways to track your cycle, and when you should see your doctor.
What Are Irregular Periods?
A menstrual cycle is defined as the time from one period to the next. The length varies from person to person.
For most adults, cycles that occur roughly every 21 to 35 days fall within the normal range. A period typically lasts between two and seven days. A cycle can be considered irregular when the timing is more variable, periods occur very frequently, or there are long gaps between periods. Irregular periods can look different for everyone, but some signs can include:
- Periods occurring more frequently or more sparsely
- Periods skipping or gaps of over a month
- Changes in how long your period lasts
Bleeding that is much heavier or lighter than usual - Bleeding that occurs between periods or spotting
You should pay attention to changes in your own patterns rather than compare yourself to others.
Some Causes of Irregular Periods
Everyone’s irregular periods can be caused by different things that range from temporary and benign to more serious and requiring medical attention.
- Hormonal Imbalance
Changes in hormones caused by things like puberty or menopause can lead to irregular ovulation. This, in turn, can cause periods to arrive early, arrive late, or not arrive at all.
Sometimes people skip or are unaware that they are pregnant. Irregular periods do not prevent someone from getting pregnant.
If your period is irregular and you assume it is due to stress or hormones, you should take a pregnancy test instead.
- Stress and Emotional Changes
Distress can interfere with ovulation in many ways, causing variable menstrual cycles.
Long-term stress, anxiety, major life changes, or a lot of emotional distress may change a person’s menstrual cycle.
To help stabilize your cycles, try to give your body what it needs to function well, such as sleep and regular meals, but do not assume stress is the sole reason for all irregular cycles.
- Weight Changes
Weight can affect hormone production and ovulation. Significant weight loss or gain can definitely affect your cycles.
Being extremely underweight or overweight can cause menstrual disturbances.
If you experienced a major change in weight, diet, or exercise, mention that to your doctor.
- Excessive Training
The “athlete’s triad” occurs when you consistently put your body through intense physical activity while severely undereating.
This causes disturbances in menstruation. It is seen in those who perform competitive physical activities, especially when combined with caloric restriction. If you notice a major change in your menstrual cycles after an increase in training, it should be addressed.
- Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is one possible explanation for having irregular periods. It can affect the consistency of your cycle, but it may involve more than just irregular periods.
PCOS can present in other ways, such as weight gain, weight loss, difficulty or even inability to conceive, excess hair, acne, and changes in your menstrual pattern.
While irregular periods can indicate PCOS, other factors are considered in the diagnostic process. A doctor will consider additional factors such as symptoms, case history, and exam results.
- Thyroid Issues
The thyroid plays a role in the functioning of other bodily systems, including the menstrual system.
An underactive or overactive thyroid can lead to menstrual irregularities.
Irregular periods accompanied by unusual exhaustion, changes in your weight, or other new symptoms should be discussed with a doctor.
- Hormonal Birth Control
Some methods of hormonal contraception can change menstrual flow. For example, pills, injections, IUS (intrauterine systems), and some other forms of hormonal contraceptives can cause your period to be lighter, less frequent, or even stop for some people. Changes can occur when starting or stopping a form of contraception.
Concerns about changes in your menstrual flow should be discussed with your healthcare professional before stopping contraceptives on your own.
- Certain Medications
Some medications can change your menstrual cycle, such as certain antidepressants, some antipsychotic medications, chemotherapy, and other types of medication.
Changes in your menstrual cycle should be reported to your healthcare professional if you are on medication. They can decide if the medication is the reason for the change.
Irregular Periods at Different Stages in Life
The significance of irregular periods can vary according to your age and your reproductive stage.
- During the Teen Years
The first few years following the onset of menstruation are often marked by unpredictable periods due to inconsistent ovulation. Longer and more unpredictable cycles are possible during this time.
Concerning symptoms include chronic heavy bleeding and slow or no recovery between heavy bleeding episodes. These symptoms, as well as prolonged gaps between periods, should be discussed with a healthcare professional.
- During the Reproductive Years
Irregular periods are worth noting if they were previously predictable.
Weight changes, stress, depression and anxiety, changes in medication, hormonal birth control, PCOS, thyroid conditions, and other issues can all lead to irregular cycles.
- During Perimenopause
The approach of menopause makes periods less predictable due to changing levels of reproductive hormones. Cycle length can vary and may even include skipped periods.
During perimenopause, pregnancy is still possible until true menopause starts, so a missed period cannot be assumed to be due to menopause.
- Irregular Cycle Tracking
Tracking your menstrual cycle can help you understand it better and help a healthcare professional understand it as well.
Apps, calendars, and diaries are the most straightforward ways to track your cycle.
Record:
The first day of every period
The last day of every period
Total number of days of bleeding
Any heavy bleeding during the period
Spotting between periods
Whether bleeding is light, moderate, or heavy
Whether there is any pain
How stressed you are
How much you exercise
How much you eat
How much you weigh
Any medication you take or use that may affect your periods, such as steroids, antidepressants, antihistamines, etc.
Any contraception you use, as it may affect your periods
The first day of bleeding in each cycle is considered Day 1 of that cycle. Tracking multiple cycles will help you determine whether your periods fall within a normal range of variation or are actually irregular. You should see a doctor for your irregular periods if your usual pattern of periods changes, even a little. You may not need to see your doctor for irregular periods that occur only once in a while.
The NHS advises that patients visit a doctor if their periods are painful, last longer than seven days, are accompanied by signs of weight gain, fatigue, growing facial hair, changes in skin, or if there is bleeding between periods.
A doctor also needs to be consulted for the following issues:
If your periods become irregular after having regular periods
If your periods are severely prolonged and heavy
If you experience bleeding between periods
If there is pain in your pelvis
If you experience symptoms that may be related to a hormonal problem
If you have difficulty becoming pregnant
If there is a significant change in your periods
Persistent absence of periods should also be evaluated. You need to see a doctor if you have missed three or more periods.
- Irregular Periods and Fertility
Irregular periods do not necessarily mean that you will not be able to get pregnant.
Irregular cycles may indicate that ovulation is happening irregularly. Without regular ovulation, predicting fertile days is not possible, which may be a barrier to getting pregnant.
If you are trying to get pregnant and have irregular periods, you should contact your doctor to see if there is a reason for irregular ovulation.
What a Doctor May Check
The evaluation for irregular periods is determined by a combination of your symptoms, age, and unique situation.
A healthcare professional may ask about:
Your regular menstruation cycle and any variations from your normal cycle
Whether you may be pregnant
Your medications and contraceptives
Your weight and how it has changed
The level of physical exertion you have had recently
Any symptoms of stress you have been experiencing
Your past medical history
Any other symptoms
Based on the circumstances, your healthcare professional may order one of many possible tests to determine the possible cause. Thyroid problems, PCOS, pregnancy, hormonal changes, and other medical issues often require different types of evaluation. There is no one-size-fits-all testing in these situations. Each case must be assessed on its own merits.
There are different ways to treat irregular cycles.
Lifestyle changes can lead to changes in menstrual cycles. Cycles may return to prior patterns if you return to a previous lifestyle. A new lifestyle may require a new cycle pattern and may help address a medical condition. You may need medication to treat a thyroid problem and a PCOS treatment plan tailored to your symptoms and personal goals.
Hormone-based birth control may also be used to address irregular periods in some cases.
There is no single treatment that works for everyone with irregular periods.
Healthy Habits That Support Menstrual Health
- Though they may not cure every case, healthy habits and lifestyle changes may help.
- Healthy Habits to Help Your Menstrual Health
- Eat healthy, balanced meals every day.
- Avoid crash diets and extreme calorie restriction. Your body needs enough food to function properly.
- Regular, moderate exercise is healthy. Extreme exercise combined with poor nutrition may have negative effects on your menstrual cycle.
- Manage Stress
Managing stress can positively affect overall health and can be helpful when stress is contributing to cycle changes.
- Get Enough Sleep
Having a regular sleep schedule supports overall health and makes it easier to maintain other healthy habits.
- Track Your Cycle
Recording your periods allows you to spot changes and, when evaluating symptoms, provides useful information for your doctor.
When Irregular Bleeding Should Be an Immediate Concern
Not all irregular periods are emergencies, but some situations require immediate care.
For example, one symptom of heavy bleeding is soaking through several pads or tampons in an hour for multiple hours. This is considered heavy bleeding and should be taken seriously.
Bleeding during pregnancy should also be an immediate concern because it is caused by different factors than typical irregular periods.
If you experience other symptoms along with bleeding and feel weak or ill, seek immediate care.
Final Thoughts
Many things can affect your cycle for various reasons, and something irregular does not always mean there is a serious issue. Weight loss or gain, extreme exercise, pregnancy, stress, hormonal contraceptives, puberty, menopause, PCOS, thyroid conditions, and many medications can alter your cycle. The first and most important step is to figure out what your normal cycle is like. Note how often your periods occur, how long they last, and how heavy the bleeding is. Also note any unusual symptoms that come with your period. Talking to a healthcare professional about irregular periods becomes particularly important if your regular patterns change, if you have unexpected and/or heavy bleeding, or if you have been having difficulty becoming pregnant.
Irregular periods do not automatically indicate a specific medical diagnosis. A combination of cycle tracking and appropriate medical advice can help explain what is happening with your periods and help you decide whether you need medical treatment.
