Help! Why are my periods so irregular?

Women's Health

by Andrea Palmer, MD

Oct 15, 2021

Ever feel like you can’t keep up with your monthly flow? Or that sometimes you go so long in between periods you would swear there is something wrong? You may realize that you have an irregular menstrual cycle, but how do you know when it becomes an issue?

Let’s talk about what’s normal with periods—and what’s not.

First, what’s “normal” for a period?

Typically, your period should occur on average every 21-35 days and last about 2-8 days. If the time between your periods starts to change, you begin to lose more or less blood during your period than usual, or the number of days that your period lasts varies a lot, then you might have an irregular period.

Common causes of irregular periods

There’s a long list of potential causes of an irregular period. The most common causes we see include:

  • Changes in your body’s level of the hormones estrogen and progesterone, or perimenopause
  • Use of birth control pills or other medications
  • Physical changes in the uterus like polyps or fibroids
  • Polycystic ovary syndrome (PCOS)
  • Thyroid problems
  • Endometriosis
  • Pregnancy or breastfeeding
  • Stress
  • Excessive exercise
  • Significant weight loss or gain

Are you surprised by the last few items on that list? Some common causes for irregularity that you may not think of are stress, over-exercise and significant weight gain or loss. You might not realize the negative impact these things can have on your body—exercise and weight loss are good things, right? But too much exercise can put unrealistic expectations and excessive stress on your body that impact your hormones, including the ones responsible for your period. Weighing too much or too little can also interfere with production of these hormones, which is why maintaining a healthy weight is key.

Related: Heavy periods and what you can do about it

How we can fix it

The good news is, you may not need to fix it! An irregular period alone is not a health hazard, but it’s usually a good idea to get to the bottom of what’s causing it. Especially if your periods being unreliable bothers you or if you feel like you may need further evaluation or treatment for an underlying condition, talk to your OB/GYN. We can help!

Two of the most common conditions that may be the source of your irregular period are polycystic ovary syndrome (PCOS) and hypothyroidism. Typically, treatment for these conditions involves medication, such as birth control or thyroid hormones, used to balance your current hormone levels. However, treatment should be individualized to your personal needs and preferences, and medication is not always the answer. Again, your OB/GYN can help figure out what works for you.

Some women also find lifestyle changes like the following can help improve period regularity, but always consult your OB/GYN about any major changes:

  • Adjusting work outs: Lowering the intensity of your exercise can be helpful if your period irregularity is caused by low body weight, consuming too few calories or over-exercising.
  • Stress management: Make time for you by talking to a therapist or starting meditation.
  • Hydration: Make sure you’re drinking plenty of water.
  • Weight and nutrition: Maintain a healthy weight through a balanced and nutritious diet.
  • Natural remedies: Natural home remedies including ginger, cinnamon and apple cider have been known to help regulate menstrual cycles. Always consult your doctor before beginning a new at-home regimen.

When to talk to your OB/GYN

If you have a regular period and then all of the sudden it changes, you should consult your OB/GYN. He or she will likely perform a physical exam and other tests to determine the cause.

Some symptoms are often signs of something more serious. If you experience any of the following symptoms, don’t hesitate to make an appointment with your OB/GYN or primary care physician.

  • Miss three or more periods in a year
  • Get your period earlier than every 21 days
  • Get your period later than every 35 days
  • Bleeding more than usual
  • Bleed for more than a week (7 days)
  • Have more pain than usual during your period

Every woman is different, and there’s no one-size-fits-all approach. Your OB/GYN can help you figure out what “normal” looks like for you and keep you feeling healthy.

Don’t have an OB/GYN? Find one near you today.

About the Author

Andrea Palmer, MD, is an obstetrician-gynecologist (OB/GYN) on the medical staff at Baylor Scott & White All Saints Medical Center – Fort Worth.

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