Irregular Menstrual Periods: Symptoms, Causes, Treatment

Irregular Menstrual Periods: Symptoms, Causes, Treatment

Irregular Menstrual Periods, Menstrual periods usually last four to seven days and occur approximately every 28 days. Examples of irregular periods include periods that are less than 21 days apart or more than 35 days apart, skipping three or more periods in a row, and periods that are much heavier or lighter than usual.

What is Irregular Menstrual Periods?

Most women’s periods last four to seven days. Your period usually occurs every 28 days, but normal menstrual cycles can range from 21 days to 35 days. In fact, the average cycle length is 29 days. Many things cause irregular periods (or irregular menstruation), such as changes in hormone levels, stress, certain health conditions, medications and more.

What are examples of Irregular Menstrual Periods?

• Menstrual periods occurring less than 21 days or more than 35 days apart.
• Missing three or more classes in a row.
• Menstruation (bleeding) that is much heavier or lighter than normal.
• Menstrual periods lasting longer than seven days.
• The length of time between cycles varies by more than nine days. For example, one cycle is 28 days, the next 37 days and the next 29 days.
• Menstrual periods accompanied by severe pain, cramps, nausea or vomiting.
• Bleeding or spotting between periods, after menopause or after sexual intercourse.
• Complete wetting of one or more tampons or sanitary pads within an hour.

Your menstrual cycle may not always be predictable, and this may not be a problem. It is normal to have slight changes in the length of your cycle, or to have a period that seems a little heavier or slightly runny than your previous period. Menstrual irregularities are quite common and you do not need to be able to predict the exact day of your cycle for it to be considered “normal”.

Irregular Menstrual Periods Symptoms

Conditions related to Irregular Menstrual Periods

• Amenorrhea: A condition where your periods stop completely. Not having periods for 90 days or more is considered abnormal unless you are pregnant, breastfeeding or going through menopause (which usually happens between the ages of 45 and 55). If you didn’t start menstruating until you were 15 or 16, or within three years of your breasts developing, you may also have amenorrhea.
• Oligomenorrhea : A condition in which your periods are infrequent. You may go more than 35 days between periods or have six to eight periods a year.
• Dysmenorrhea: A medical term for painful periods and severe menstrual cramps. Some discomfort during your cycle is normal.
• Abnormal uterine bleeding : Abnormal uterine bleeding is bleeding between periods, prolonged bleeding or excessively heavy menstrual bleeding.

Symptoms and Causes of Irregular Menstrual Periods

What causes Irregular Menstrual Periods?

Irregular Menstrual Periods can have many causes, from stress to more serious underlying medical conditions.

Medical conditions and Irregular Menstrual Periods

Some health problems are associated with delayed periods. These include

• Endometriosis :
  Endometriosis occurs when endometrial tissue grows outside your uterus. The tissue usually attaches to your ovaries or fallopian tubes. Endometriosis can cause abnormal bleeding, cramps or severe pain before and during your period.
• Pelvic inflammatory disease :
  Pelvic inflammatory disease (PID) is a bacterial infection that affects the female reproductive system. It is usually caused by an untreated sexually transmitted infection (STI). The bacteria enter your vagina and spread to your uterus and upper genital tract. Symptoms of PID include thick vaginal discharge with an unpleasant odor, irregular periods and pelvic pain.
• Polycystic ovary syndrome:
  In polycystic ovary syndrome (PCOS), your ovaries produce large amounts of androgen, a type of hormone. This hormone prevents or delays ovulation and causes irregular periods. People with PCOS may stop menstruating altogether.
• Primary ovarian failure:
  This occurs in women under the age of 40 whose ovaries are not working properly, causing delayed or irregular periods. It can occur during cancer treatment with chemotherapy and radiation or if you have certain autoimmune conditions.
• Thyroid or pituitary gland disorders:
  Hypothyroidism (underactive thyroid), hyperthyroidism (overactive thyroid) and other thyroid or pituitary gland disorders affect your hormones. This causes your periods to be irregular.
• Bleeding disorders :
  If you have a bleeding or blood clotting disorder, you may experience increased menstrual bleeding.
• Uterine cancer or ovarian cancer:
  Some cancers can affect a person’s menstrual period. Changes may include heavier bleeding than usual or a delayed period.

Irregular Menstrual Periods Causes

Lifestyle factors and periods of Irregular Menstrual Periods

Interruptions or changes in your daily routine can affect your menstrual cycle. Some examples of lifestyle factors are:

• Stress.
• Significant weight gain or loss.
• Exercise routines that lead to very low body fat (long distance runners, dancers or gymnasts).
• Viruses or other diseases.

Other causes of abnormal menstruation

Some medications, complications of pregnancy or breastfeeding can also cause irregular periods. Other causes include:

• Birth control pills : Most birth control pills contain a combination of hormones. The pills prevent pregnancy by preventing your ovaries from releasing eggs. Starting or stopping birth control pills can affect menstruation. You may have irregular or missed periods for up to six months after stopping birth control pills.
• Medicines, such as steroids or anticoagulants (blood thinners).
• Miscarriage or ectopic pregnancy (fertilized egg implanting outside the uterus).
• Surgery, scarring or blockage in your uterus, ovaries or fallopian tubes.

How is Irregular Menstrual Periods diagnosed?

If you feel changes in your menstrual cycle, start recording when your periods start and end. Note the symptoms, the amount of discharge or if you experience cramping, bleeding between periods or large clots. It is useful to share all of this with your health care provider.

To diagnose irregular periods, your obstetrician will ask you questions about your menstrual cycle and medical history. They will do a physical examination, including a pelvic examination. They may also order certain tests, including

• Pelvic ultrasound: Ultrasound can detect irregular bleeding caused by uterine fibroids, polyps or ovarian cysts.
• Endometrial biopsy : Your healthcare provider takes a tissue sample from the lining of your uterus. It can help diagnose endometriosis, hormonal imbalances or precancerous cells.
• Hysteroscopy: A procedure that allows your doctor to look inside your uterus to diagnose and treat specific causes of abnormal bleeding.

Irregular Menstrual Periods Treatment

How is Irregular Menstrual Periods treated?

Treatment of Irregular Menstrual Periods varies according to the underlying cause.

Medication for Irregular Menstrual Periods

Medicines are usually the first line of treatment for irregular periods. If medicines do not work, your provider may recommend surgery. Possible medicines include:

• Hormonal birth control :
  Irregular or heavy bleeding caused by PCOS, uterine fibroids, endometriosis or other medical conditions can be managed with hormonal birth control. They also help by regulating your cycle, making it more predictable. These can be combined hormonal birth control pills containing estrogen and progestin or progestin-only birth control pills. Both types come in different forms, such as the pill, vaginal ring, injection or IUD (intrauterine device).
• Tranexamic acid :
  A medicine prescribed to treat heavy menstrual bleeding. You take a pill at the start of your period to control your bleeding.
• Painkillers :
  You can get relief from mild to moderate pain or cramps by taking an over-the-counter painkiller such as ibuprofen or paracetamol.
• Hormone therapy :
  If your irregular periods are caused by perimenopause, hormone therapy may help. It can also help with other menopausal symptoms such as vaginal dryness and hot flushes. There are risks associated with hormone therapy, so be sure to discuss these with your obstetrician.
• Antibiotics :
  Antibiotics may be given if the cause of irregular bleeding is infection.
• Gonadotropin-releasing hormone agonists:
  These drugs reduce the size of uterine fibroids and control heavy bleeding, but temporarily stop your period.

Surgery for Irregular Menstrual Periods

Surgical treatment options are available depending on your condition, age and whether you want to get pregnant in the future. Surgical treatments for Irregular Menstrual Periods include

• Endometrial ablation :
  Endometrial ablation is a procedure that uses heat, cold or different types of energy to destroy the tissue lining your uterus so that you have less bleeding during your period. To have this procedure you need to have a form of birth control. You should not have this procedure if you still want to get pregnant in the future.
• Myomectomy :
  This is a procedure to remove uterine fibroids that cause irregular bleeding.
• Uterine artery embolization:
  A procedure that cuts off the blood supply to the uterus to stop uterine fibroids.
• Hysterectomy :
  In severe cases, surgery may be needed to remove excess endometrial tissue growing in your pelvis or abdomen. If your uterus is severely damaged, a hysterectomy may be needed as a last resort.

How can I reduce my risk of Irregular Menstrual Periods?

Here are some suggestions for self-care:

• Try to maintain a healthy lifestyle by exercising moderately and eating nutritious foods. If you want to lose weight, do so gradually rather than going on diets that drastically limit your calorie and food intake.
• Make sure you get enough rest.
• Practice stress reduction and relaxation techniques.
• Reduce your prolonged or intense exercise routines.
• Use birth control pills or other contraceptives as directed.
• Change your tampons or sanitary pads every four to six hours to prevent toxic shock syndrome and prevent infections.
• See your obstetrician and family doctor for regular check-ups.

When should you see your doctor for Irregular Menstrual Periods?

See a healthcare professional if you have painful or Irregular Menstrual Periods, or if you experience any of the following symptoms

• Severe pain (cramping) during or between periods.
• Unusually heavy bleeding (wetting of a sanitary pad or tampon every hour for two to three hours) or passing large clots (larger than a quarter).
• Foul-smelling vaginal discharge.
• Period lasting longer than seven days.
• Vaginal bleeding or spotting between periods or after menopause.
• Your periods becoming very irregular after regular menstrual cycles.
• Nausea or vomiting during menstruation.
• Symptoms of toxic shock syndrome (TSS) such as fever, vomiting, diarrhea, fainting or dizziness.
• You should also see your doctor if you think you might be pregnant.

Irregular Menstrual Periods 2025

Frequently Asked Questions about Irregular Menstrual Periods

Is it normal to miss your period for two months?

Skipping one or two periods is not ideal, but it is not too worrying. Take a look at the changes in your life recently. Things like stress, a new exercise routine, losing or gaining weight, or changing birth control can affect your cycle. Call your health care provider if you miss your period for three or more months in a row, or if you experience other unusual symptoms during your next period.

How normal is a delayed period?

Small delays in your period are usually not a problem. Some people can predict their periods exactly, while others cannot. If you notice a sudden change in the time between cycles or the length (days) of your period, especially if it is significant, contact your provider. This does not always indicate a problem, but it is a good idea to get it checked.

When are Irregular Menstrual Periods more common?

Irregular periods are more common when you first start menstruating (around 9-14 years old) or during perimenopause (around 50 years old or just before menopause).

Should I worry if my periods are irregular?

Irregular periods may not be something to worry about because some changes in menstruation are normal. What is normal for you may be different from what is normal for your best friends. However, certain symptoms may be a sign of a bigger problem.

Contact your gynecologist if you are worried about your menstrual cycle or if you are trying to get pregnant and have unpredictable periods (which can make it difficult to get pregnant). They can tell you what is normal and whether treatment is needed.

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