Obstetrician-gynecologist explains reasons behind irregular menstruation

There are many joys to being a woman…but, for many, the menstrual cycle is not the most important thing. It’s estimated that you may be one of the 75% of women who experience premenstrual syndrome (PMS) symptoms, such as bloating and irritability, before your period. Your tampon or pad may bleed profusely when it arrives, so rush to do damage control before your clothes show signs of leakage. In the midst of it all, you might even encounter irregularities that leave you scratching your head as to what exactly is going on in your body and whether these newfound changes might be cause for concern.

We asked Cynthia Abraham, MD, FACOG board-certified obstetrician-gynecologist at Mount Sinai Hospital in New York City, to tell us about the causes and causes of irregular menstrual cycles.

What is a normal menstrual period?

“Normal menstruation usually occurs every 21 to 35 days and lasts for four to seven days,” says Dr. Abraham. According to the Mayo Clinic, longer cycles are more common in the years closer to the start of your first period, and cycles tend to become shorter over time.

However, normality also varies from person to person. For example, your cycle usually lasts 30 days and bleeds for 6 days, while your bestie’s cycle usually lasts 21 days and bleeds for 4 days. In either case (both of which are considered “normal” in their own right), any significant deviation from normal conditions can be considered irregular. This applies not only to your cycle and how long it lasts, but also to the severity of your cycle and period and any new (or worse) symptoms that occur.

What are the causes of irregular menstrual cycles?

Many factors—both short-term and more medically significant—can trigger irregular periods.

“Stress and excessive weight gain or loss, especially in those who engage in strenuous exercise that results in very low body fat, are very common lifestyle factors that lead to irregular menstruation,” Dr. Abraham shares. She adds that if you’ve recently experienced menstrual irregularities, she adds You may also notice temporary changes in your menstrual pattern as you recover from a viral infection or other stress-causing illness.

Hormonal birth control (including birth control pills) and intrauterine devices, as well as certain medications, can also affect your menstrual cycle.

According to the U.S. Department of Health and Human Services, medical and health problems that can cause irregular periods include:

• There’s something wrong with your ovaries
• Thyroid and adrenal gland problems
• uncontrolled diabetes
• eating disorder

Of course, perimenopause (the transition to menopause, usually in your late 40s to early 50s) will also mark a significant transition until you stop menstruating. You also need to rule out pregnancy if your period is due.

lighter period

If your period is lighter than usual, it might just be because your biological clock is ticking. “It’s common for menstrual bleeding to decrease as we age,” says Dr. Abraham. (In my case, I’ve recently noticed that my own periods are lighter than usual: a welcome reminder of my tampon use, of course, but also a wake-up call that I’m far from a Spring Chicken.

Heavy menstrual flow

If your period is heavier than usual, it may be time to talk to your ob-gyn. “Increased menstrual flow is more worrying [than lighter periods] and requires medical evaluation as it may indicate a new hormonal imbalance or structural problem such as fibroids,” warns Dr. Abraham.

When to Consult Your Obstetrician-Gynecologist

Some menstrual irregularities are harmless, while others may be more concerning.

According to Dr. Abraham, you will need to see a doctor if:

• You need to change your sanitary napkins/tampons every one or two hours during your period
• Your menstrual cycle lasts longer than 7 days
• Your period pain cannot be treated with over-the-counter medications such as Motrin or Tylenol

Penn Medicine adds that if you haven’t had your period in the past 90 days, you should seek medical intervention.

Of course, you can discuss any more minor changes in your menstrual cycle during your annual OB-GYN visit and see if any intervention is needed.

Important points about irregular menstruation

There’s a fairly large window into what a normal period looks like from one woman to another. However, if your period is noticeably different than usual, that is, if you bleed heavily, your period lasts for more than a week, or if painful symptoms appear suddenly or worsen, you’d better talk to your healthcare provider.

For less serious cases – for example, if your period and/or cycle length is off by a day or two or seems to be getting lighter – you don’t need to stress yourself too much. Slight changes are not a major cause for concern. However, Dr. Abraham says that if they’re accompanied by other signs of wearing them that feel worse, a little more TLC can have some benefits for your menstrual health and overall health.

To promote regular menstruation, she recommends managing stress. Her top recommendations include getting plenty of rest, as well as relaxation techniques like yoga and acupuncture. “In addition to eating healthy and exercising moderately, these can only help,” she shares. While these tips aren’t game-changing, they certainly can keep your mind, body, and hormones healthy, happy, and in harmony.

If you need some extra support to relieve PMS symptoms (eg: hormonal acne, bloating, mood swings, discomfort, and breast tenderness), you may want to check out a hormonal support supplement, such as HUM’s SOS PMS Gummies. Chasteberry helps relieve premenstrual syndrome, and vitamin B6 helps balance mood. All the while, cranberries add some extra support to the urinary tract.