Irregular periods, when should you be concerned
Irregular periods can be a normal occurrence or a reason to see your doctor.
Irregular cycles have many causes, some are temporary, some are chronic and a few are serious. If you experience irregular cycles, you may want to talk to your doctor.
For us women, we have a cycle all our own. We call it the menstrual cycle, the period, a visit from Aunt Flo, our Moon Time, the Curse, etc. Our periods can also be viewed as a 5th vital sign (Normal vitals signs are heart rate, respiratory rate, blood pressure and temperature). How the menstrual cycle goes can reflect a lot of information about our health – hormone levels, thyroid function, stress, anemia, inflammation, pregnancy, menopause, etc. Paying attention to our periods is very important, as is knowing when to look for help with menstrual irregularities.
A quick side bar is that your period should not be a painful, prolonged, horrific event. It is a particular soap box of mine to make sure women are aware that they can (and should) have regular, non-debilitating, non-hemorrhaging periods each and every month. So if you are one of the millions of women who have accepted cramps, clots, severe mood swings, heavy periods, irregular periods or unbearable pain, please seek a holistic provider who can help you improve your menstrual cycle.
Now back to our regularly scheduled content. Irregular periods happen for a variety of reasons so one or two unusual cycles are nothing to be immediately concerned about. Hopefully, you are tracking your cycles so that you know what is normal for you. While the average menstrual cycle is 28 days, cycles ranging from 21-35 days can be considered normal. Menstrual bleeding averages at 5 days but can range from 3-7 days. Day 1 is counted as the first day of bleeding. Utilizing a period tracking app helps to take the guesswork out of assessing how regular your cycle is. I personally like Flo but according to Women’s Health Magazine, other good options include Clue, Ovia, Eve by Glow, MagicGirl, MyFlo, Cycles, Glow and Cycle Tracking.
Having a cycle vary by a few days either shorter or longer is also not so unusual. A stressful event, travel, irregular sleep, syncing up with a best friend, getting sick and normal hormonal shifts can cause a period to be a few days shorter or longer. Missing a period entirely should prompt you to take an at-home urine pregnancy test just to make sure unless your cycles are frequently missed, or you are on a hormonal birth control designed to cause fewer periods.
If you typically have a regular menstrual cycle, there are still many reasons why a cycle or two will be abnormal. If, however, your cycle is persistently irregular, you may want to talk to your doctor about it. Your period may be disrupted by thyroid problems as the thyroid gland regulates a lot of other systems in the body. This can also cause sluggish digestion, weight gain or loss, changes to your hair and nails and slow or rapid heart rate.
Irregular cycles can be a sign of PCOS (polycystic ovarian syndrome). PCOS is a “syndrome” which means it is a collection of symptoms, and not every woman has each one. Women with PCOS can experience irregular or skipped periods, infertility, blood sugar issues, weight gain, facial hair growth and acne. This syndrome is associated with elevated androgens (testosterone), which disrupts the normal balance of progesterone and estrogen. It will be worked up with a history, physical, blood work and possibly an ultrasound to look for cysts on the ovaries.
Many women who enter perimenopause start to notice their cycles become irregular. Perimenopause is loosely defined as the time before and around menopause. Many women experience this in their 40s, but occasionally, symptoms can begin in the 30s. As hormones begin to fluctuate, cycles may be longer or shorter, and you may also notice the other classic menopausal symptoms: mood changes, hot flashes, weight gain and night sweats.
Other types of hormonal imbalances can also disrupt your menstrual cycle. Some women experience excess estrogen – this can come from outside sources (pesticides, plastics, bleached products), birth control or your own body. Being overweight is a risk factor for increased estrogen as fat cells can secrete their own estrogen, or rarely, a woman may have a tumor that produces excess hormones.
Nutritional imbalances can cause period irregularities as well. Women who are very athletic will sometimes have low body fat or very low cholesterol levels, and the body will not be able to make enough estrogen and progesterone. Cholesterol is the precursor for all the sex hormones in our bodies. Severe anemia can also cause irregular cycles and is usually due to iron deficiency from heavy periods, malabsorption of nutrients or a restrictive diet. Blood work can usually identify these concerns.
Finally, there are some potentially serious causes of period issues that are, fortunately, rare. Younger women may go through POF (premature ovarian failure), which is a serious disorder that causes the ovaries to lose function earlier in a woman’s life than they should. This condition is very rare. Cervical and endometrial cancer can also cause period changes – most commonly heavy periods, bleeding between cycles, abnormal discharge and bleeding with intercourse.
Make sure you are paying attention to your body and your menstrual cycle. If you are noticing irregular cycles or a change in your cycle, speak to a holistic doctor or your gynecologist to explore what the cause may be. Getting an accurate diagnosis is essential to receiving the right treatment.