Menstruation is a source of worry for many women, whether it doesn’t come on the expected date or shows up much earlier than planned. For those who have always had irregular periods, they may be used to these comings and goings of this monthly friend. But what about women who always had a normal cycle and suddenly experience irregular menstruation?
What would be the ideal menstrual cycle?
An ideal menstrual cycle is considered to be between 21 and 35 days. But not all women fit into this timeframe, especially from early on, even in their first year of menstruating. Many women may have cycles that alternate the date their period arrives or leaves, and they struggle with irregular menstruation1.
We can say that cycles between 21 and 40 days are tolerable. Those that edge toward total madness, over 40 days in length. These can really distress a woman, especially if she’s trying to become pregnant. Knowing when to seek help to detect the cause of irregular menstruation is crucial. The causes can be varied and are not always easy to identify by the woman herself. That’s why it’s very important to have a trusted health professional to consult in case of doubt.
What can cause an irregular cycle?
Most sudden irregular cycles are caused by hormones. If one or more hormones are out of sync, with significant alterations, the cycle can indeed become irregular. Most complaints about irregular menstrual cycles are about very late periods or even two cycles of bleeding within a single month. Spotting is one of the most common complaints and can raise an important question: why do I bleed so much?
The truth is that each cycle may change according to the time it takes for a woman to become fertile. In other words, what varies within the cycle is the follicular phase. The follicular phase may last only about seven days in short cycles, such as those of 21 days. But it may last more than 20 days in long cycles of about 40 days.
As already explained in regards to the female fertile window and also cervical mucus, the cycle can vary from woman to woman. So, being attentive is vital to notice if your cycle is irregular, which would also result in irregular periods.
Birth control pills and other medications
Another factor that causes irregular periods is the use of medication. Birth control pills or even morning-after pills (MAP) can alter your cycle if not used correctly2. Birth control is intended to help regulate the cycle, if it’s the correct medication for you and taken regularly. If taken on alternate days, or at very different times, it can lead to irregular periods.
Polycystic ovaries
Another factor that leads to irregular menstruation is the presence of polycystic ovaries3. Women with this syndrome have a strong tendency toward irregular or very long cycles. However, this is equally detrimental if she wants to get pregnant. Women with irregular periods might not be able to identify ovulation, making it even harder to conceive.
Main causes
Other reasons may also cause irregular menstruation, such as:
- Excess weight
- Hormonal changes
- Anorexia and bulimia
- Endometriosis
- Stress
IMPORTANT: There are many reasons for irregular periods. That’s why each case should be carefully analyzed to find the real cause and treat it appropriately.
How to detect the cause?
Detecting irregular menstruation is relatively simple, as it tends to change every cycle. The frequency and dates will vary each month. It may take more than 40 days to show up, and sometimes even a whole year. Cases like this must be investigated by a doctor.
Some women also experience bodily changes like weight gain or loss, increased hair growth, irritability or decreased sex drive. All initial investigations should be done by a doctor, who should order hormone tests including:
- Progesterone
- Estrogen
- Prolactin
- Testosterone
- LH
- FSH
- TSH and free T4
Along with blood tests, an ultrasound will be needed. With this, it’s possible to detect visible problems in the uterus that could be interfering with your cycle and causing irregular menstruation. Then, the best treatment will be determined by your healthcare professional.
How to regulate menstruation?
Treatment for irregular periods is, in theory, simple. If the cause of it all is just hormonal, treatment with birth control pills or regulators appropriate for that case could be an alternative.
Depending on the cause, some treatments do involve contraceptives. But for women who want to get pregnant, medications that regulate menstruation but do not suppress ovulation are recommended.
There are some good alternative medications to control irregular periods. But they are only indicated after ovulation has occurred, which should be detected based on the follicular phase and the woman’s fertile window. To learn how to identify your fertile window, you can check your mucus and your basal temperature.
Make your doctor your best friend!
Readers’ questions:
How to calculate the fertile window with irregular menstruation?
The fertile window for women with irregular cycles should be measured by two factors: the cycle length and observation of cervical mucus. To calculate, simply take the longest and shortest cycles. Then calculate an average. For example, for 32-day and 40-day cycles: 32-14 = 18th day of the cycle, 40-14 = 26th day of the cycle. So, the woman should try to have intercourse between the 14th and 26th day of the cycle to maximize chances of pregnancy.
How to use the calendar method with irregular periods?
Since it is very difficult to be sure about the fertile period in an irregular cycle, we do not recommend using the calendar (rhythm) method. This method is only recommended and more reliable for women with regular cycles.
Can women with irregular periods get pregnant?
Of course, just because periods are irregular doesn’t mean a woman isn’t ovulating, unless the irregularity is caused by other health problems that block fertility. But in general, irregular menstruation does not make it impossible for a woman to get pregnant; she just needs to track her fertile days.
Read also: Menstruation With Clots – What’s Happening?
