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If your menstrual cycle is irregular from time to time, it’s probably no big deal. But do you know how to tell if you have reason to be concerned?
Your menstrual cycle isn’t always like clockwork. While some women get their periods right on schedule every 28 days, other women’s cycles aren’t so predictable.
“At least 30 percent of women have irregular periods during their childbearing years,” says Amy Autry, MD, a clinical professor of obstetrics-gynecology and reproductive sciences at the University of California, San Francisco. While an irregular cycle is not usually a problem, it can occasionally signal health complications.
What if it isn’t down to puberty or menopause?
Many women experience widely spaced periods, typically having one or two periods every six months. This may concern you, but it is very unlikely that there is a serious underlying cause.
If you are worried about the frequency of your periods, you should see your GP.
Causes of irregular periods
Your menstrual cycle can be disturbed if you change your method of contraception or you have an imbalance of the hormones oestrogen and progesterone.
It’s not unusual to have a hormone imbalance for a few years after puberty and before the menopause. This can cause your menstrual cycle to become longer or shorter. Your periods may also become lighter or heavier.
If your irregular periods are caused by these age-related factors, you won’t usually need to see your GP.
The following lifestyle factors can also upset your balance of hormones and cause irregular bleeding:
- extreme weight loss or weight gain
- excessive exercise
When Is a Period Irregular?
A normal menstrual cycle lasts 28 days, plus or minus seven days. Menstrual bleeding is considered irregular if it occurs more frequently than every 21 days or lasts longer than 8 days. Missed, early, or late periods are also considered signs of an irregular cycle.
To determine whether your menstruation schedule is irregular, count from the last day of your previous period and stop counting on the first day of your next. Repeat this for three months. “If the number of days between stopping and starting your period is significantly different each month, you have an irregular cycle.
How is a diagnosis made?
The diagnosis of polycystic ovaries is made on the basis of one or more blood tests to measure hormone levels, often with a pelvic ultrasound scan of the ovaries.
Do Irregular Periods Need Treatment?
Treatment of irregular periods depends on the cause and your desire to have children in the future. Irregular periods can be caused by many different things. Changes in your body’s level of the hormones estrogen and progesterone can disrupt the normal pattern of your period. That’s why young girls going through puberty and women approaching menopause commonly have irregular periods.
Other common causes of irregular periods include:
- Having an intrauterine device (IUD)
- Changing birth control pills or using certain medications
- Excessive exercise
- Polycystic ovary disease (PCOS)
- Pregnancy or breastfeeding
- Overactive thyroid or hyperthyroidism
- Thickening of or polyps on the uterine lining
- Uterine fibroids
A less common cause is severe scarring (adhesions) of the lining of the uterus, a condition known as Asherman syndrome.
Prevention and Treatment of Irregular Periods
If stress is a possible culprit in your irregular cycle, try stress management techniques, such as meditation, yoga, tai chi, visualization, and biofeedback. Avoid over-exercising and try not to diet excessively, as doing so can interfere with your menstrual cycle.
Oral contraceptive pills may be prescribed to get your period back on track. But if you’d rather travel the natural treatment road, consider black cohosh. This medicinal herb is sometimes used for menstrual irregularities and premenstrual syndrome, though rigorous scientific studies haven’t verified these properties. Black cohash should not be used if you have any symptoms of or a past history of liver disease.
You may have heard that completely darkening your room at night will help regulate menstrual cycles but whether it really works is unknown.
A couple of irregular periods per year are usually nothing to worry about. Any more than that, and you should see a doctor to be sure an ovulation problem or health condition isn’t the cause. However, you might want to rule out pregnancy first. “If you’ve had sexual relations in the past month, take a home pregnancy test first,” advises Autry. If the test is negative, then you can explore other options and talk to your doctor about how to get your menstrual cycle back on track.