Up to 25% of women experience menstrual irregularities, making it a common health issue. An irregular menstrual cycle is when your period is shorter, longer, lighter, heavier, or more unpredictable than usual. Some women may also have bleeding between periods, painful cramping, or other problems.

Your period can say a lot about your health. How much should you worry about menstrual irregularities? And when do you need to see a doctor?

TopLine MD Alliance is here to explain everything you need to know, from common causes of menstrual irregularities to medical conditions linked to abnormal menstrual cycles. We’ll also share how your age and lifestyle can impact your menstrual cycle, why tracking your cycle is so important, treatment options for menstrual irregularities, and more.

Definition of a “Normal” Menstrual Cycle

Your menstrual cycle is counted from the first day of one period to the first day of the next. For most women, a normal menstrual cycle ranges from 21-35 days, with 2-7 days of bleeding that usually requires a pad or tampon change every 4-8 hours.

Some menstrual symptoms that are considered normal include:

  • Bloating
  • Breast tenderness
  • Cramping in your back or lower abdomen
  • Mood swings
  • Irritability
  • Difficulty sleeping
  • Acne breakouts

Premenstrual syndrome (PMS) refers to these physical and emotional symptoms occurring days or weeks before your menstrual period begins. Over 90% of women experience PMS during their lifetime.

When Your Menstrual Cycle is Abnormal

What’s “normal” for you may be different from what’s normal for someone else, and most periods vary slightly from cycle to cycle. However, these symptoms of an abnormal menstrual cycle could signal something is wrong:

  • Periods that occur less than 21 days or more than 35 days apart
  • Periods that last longer than seven days
  • Missing three or more periods in a row when not pregnant
  • Bleeding that is much heavier or lighter than usual
  • Soaking through a pad or tampon in 1-2 hours
  • Severe pain, cramping, nausea, or vomiting accompanying your period
  • Bleeding or spotting between periods

Common Causes of Menstrual Irregularities

There are many causes of menstrual irregularities like these, some within your control and some beyond it. Any disruption or change in your daily routine can impact your cycle, such as:

  • Stress
  • Significant weight loss or gain
  • Extreme physical activity
  • Taking certain medications, such as birth control or steroids

Several medical conditions are associated with menstrual irregularities, including:

  • Polycystic ovary syndrome (PCOS) – Women with PCOS produce excess hormones that delay or prevent ovulation, leading to irregular periods or stopping menstruation completely.
  • Endometriosis – This condition occurs when endometrial tissue grows outside your uterus, often attaching to your ovaries or fallopian tubes. It is known to cause abnormal bleeding, severe pain, and other symptoms.
  • Thyroid disorders – Hypothyroidism (underactive thyroid), hyperthyroidism (overactive thyroid), and other thyroid issues can also affect your hormones and result in irregular periods.

Certain cancers (such as uterine cancer or ovarian cancer), bleeding disorders, and other conditions can also cause menstrual irregularities that indicate underlying health issues. If you experience any of the abnormal symptoms listed above, consulting a  TopLine MD Alliance affiliated provider is recommended.

How Age Impacts Your Menstrual Cycle

Irregular periods and longer cycles are common for the first few years after menstruation begins, then become more regular as you age. Menstrual cycles are usually most regular between the ages of 25 and 35.

Cycles often become irregular again in your 40s and 50s as you transition through perimenopause, the hormonal phase before menopause.

Lifestyle Factors That Can Influence Cycle Regularity

Lifestyle choices also play a role in your menstrual cycle, such as:

  • Diet – Consuming high amounts of fat, salt, sugar, caffeine, and alcohol can contribute to menstrual irregularities.
  • Physical activity – Sedentary lifestyles often lead to irregular periods. Regular exercise can help ease pain, cramps, and other symptoms.
  • Body weight – Being overweight or underweight often leads to hormonal changes that can affect your cycle.
  • Sleeping habits – Lack of sleep can Lack of sleep can disrupt your hormonal balance and circadian rhythm, leading to irregular periods.

The healthier your lifestyle is, the more regular your menstrual cycle should become.

Keeping Track of Your Cycle

No one knows your body better than you. Tracking your menstrual cycle is a great way to identify what’s normal for you and what isn’t.

If you notice changes in your cycle, document when your periods start and end, blood flow amount, any spotting, and other symptoms. This information can be very helpful to share with your medical provider.

Testing and Treatment Options for Menstrual Irregularities

Your provider will ask about your menstrual cycle and medical history and then perform a physical exam (including a pelvic exam). They might also order specific tests – such as a pelvic ultrasound, endometrial biopsy, or hysteroscopy – to examine your uterus more closely.

Medications are often the first form of treatment, depending on the underlying cause of your menstrual irregularities. Options include:

  • Hormonal birth control to help regulate your cycle
  • Tranexamic acid to control heavy bleeding
  • Hormone therapy for perimenopause symptoms
  • Pain relievers for mild to moderate discomfort

In some cases, surgical options like endometrial ablation, myomectomy, or hysterectomy may be necessary.

Protect Your Health and Fertility

When your body is trying to tell you something, it’s important to listen. Contact your provider if you notice any sudden changes in your menstrual cycle. Are you trying to get pregnant or planning to in the future? Irregular periods can also disrupt ovulation and impact your fertility. Ask your provider about treatment options that can help.

Find a TopLine MD Alliance affiliated provider near you

The TopLine MD Alliance was created by physicians who came together to make healthcare experiences better for patients. We help patients navigate the healthcare system, connecting them with top-of-the-line healthcare providers, practices, diagnostic centers, and imaging centers we trust.

To find a TopLine MD Alliance affiliated provider near you, visit us online today.

The TopLine MD Alliance is an association of independent physicians and medical practice groups who are committed to providing a higher standard of healthcare services. The members of the TopLine MD Alliance have no legal or financial relationship with one another. The TopLine MD Alliance brand has no formal corporate, financial, or legal ties to any of the affiliated physicians or practice groups.