Irregular Periods: Causes, Symptoms, and Solutions

At approximately 12 years old girls typically start menstrual bleeding.  Initially, cycles are usually irregular and may seem to happen sporadically.  However, the majority of girls develop regular monthly cycles within a year or so. Women generally experience a period every 28 days, but cycles can fluctuate from 21 to 45 days apart.  Bleeding lasts 3-6 days on average 

Menstrual cycle problems can occur at any age.  When a woman has her period more often than every three weeks, or has bleeding between cycles, or has periods lasting longer than eight days, this is abnormal.  Skipping periods or having very heavy flows or cramping is also not normal. Although period problems are very common and usually not dangerous, they can cause symptoms that range from uncomfortable, to really bothersome,  interfering with daily activities. Less commonly they can cause or be a sign of life-threatening conditions. Here, we’ll discuss the problem of irregular periods, their evaluation and potential treatment options. 

Causes of Irregular Bleeding

Irregular bleeding can stem from a variety of causes. Common causes of irregular periods include:

  • Hormonal imbalance
  • Weight loss, low body fat, and intense exercise
  • Hormonal changes that occur with puberty, menopause, pregnancy, and breastfeeding
  • Side effects of Birth control pills and intrauterine devices
  • Polycystic ovary syndrome (PCOS)

Period problems may also be caused by an underlying condition, such as:

  • Uterine polyps or fibroids
  • Thyroid disorders
  • Endometriosis
  • Cervical or uterine cancer
  • Pelvic inflammatory disease (PID)
  • Primary ovarian insufficiency (POI)

Evaluation of Irregular Bleeding

If you are having problems such as skipping periods, bleeding too heavy or too often, or spotting in between, you should be evaluated with a medical examination.  Your doctor will take your history, examine you and then order blood work and likely a pelvic ultrasound to determine the cause. In women over 35-40 years old sometimes uterine sampling (biopsy) is recommended.

Treatment of Irregular Bleeding

Irregular periods can be treated in a  variety of ways depending on the cause. Here are some commonly used treatments for irregular periods:

  • Your doctor may prescribe a medication to help with irregular periods, such as:
    • Progesterone or estrogen is often used short-term to regulate bleeding.
    • A low dose combination estrogen/progesterone birth control pill.
    • Lysteda (tranexamic acid)  to slow down heavy flows.
    • Metformin may help regulate periods.
  • For women with PCOS or those who or overweight, reaching and maintaining a lower body weight could help correct period problems. 
  • Switching to a new birth control method can correct some instances of irregular menstrual bleeding. 
  • If thyroid problems are causing irregular menstruation, treatment for the thyroid condition will commonly be administered, such as medication, surgery, or radioactive iodine therapy. 
  • Changing to a different birth control pill, if taking birth control pills
  • Very effective treatments for heavy bleeding include the Mirena IUD and Novaure endometrial ablation (a quick office-based procedure).

If you want to learn more or have further questions about irregular periods, go here for a complete Q&A

If you are experiencing period problems it’s important to seek the help of your doctor to determine the underlying cause of the problem. At Women’s Health & Wellness in Florida, our team of women’s health experts will work with you to develop an effective treatment plan.