There are many joys of being a woman… but, for many, menstrual cycles don’t exactly top the list. Before your period comes, you might be among the estimated 75 percent of women who experience PMS symptoms like bloating and irritability. When it arrives, you might bleed heavily through your tampon or pad, scurrying to do damage control before your clothes show signs of leakage. And in the midst of it all, you might even experience irregularities that can have you scratching your head as to what the heck is going on inside your body—and if these newfound changes may be cause for concern.
We asked Cynthia Abraham, MD, FACOG, a board-certified OB-GYN with Mount Sinai Hospital in New York City, to walk us through the what’s and why’s of irregular menstrual cycles.
What Is a Normal Period?
“Normal menses typically occur every 21 to 35 days and last 4 to 7 days,” says Dr. Abraham. Per the Mayo Clinic, longer cycles are more common in the years closer to when you first start menstruating, and they tend to become shorter as the years go on.
Normality, however, can also vary from one individual to the next. For instance, you might typically have a cycle that lasts 30 days with 6 days of bleeding—while your bestie has a 21-day cycle with 4 days of bleeding. In either case (both of which are considered ‘normal’ in and of themselves), any changes that notably stray from your norm can be considered irregular. This applies not only to how long your cycles and period last, but also how heavy they are and any new (or more intense) symptoms that arise.
What Causes Irregular Menstrual Cycles?
Any number of factors—both short-term and more medically significant—may trigger menstrual irregularities.
“Stress and excess weight gain or loss—especially in those engaging strenuous workouts that lead to very low body fat—are very common lifestyle factors that contribute to irregular menses,” Dr. Abraham shares. You might also notice a temporary shift in your menstrual patterns if you’ve recently recovered from a viral infection or another stress-inducing illness, she adds.
Hormonal birth control (including the pill) and IUDs can also affect your period, as can certain medications.
Per the US Department of Health and Human Services, medical and health issues that can cause irregular periods include:
- Issues with your ovaries
- Thyroid and adrenal issues
- Uncontrolled diabetes
- Eating disorders
Naturally, perimenopause (i.e., the transition to menopause, typically in your late 40s to early 50s) will also mark notable shifts until you cease to menstruate. You’ll also need to rule out pregnancy if your period is past due.
Lighter Periods
If your periods are lighter than normal, it may simply be attributed to the ticking of your biological clock. “Lighter periods are very common as one ages,” says Dr. Abraham. (I, for one, have recently noticed that my own menses are getting lighter than usual: a welcome treat for the sake of my tampon use, sure, but also a wake-up call that I’m far from being a spring chicken these days.)
Heavier Periods
If your periods are heavier than they usually are, it might be time to consult your OB-GYN. “Heavier periods are far more concerning [than lighter periods] and warrant medical evaluation, as it may be indicative of a new-onset hormonal imbalance or a structural issue such as a fibroid,” Dr. Abraham warns.
When to Consult Your OB-GYN
Some period irregularities are innocuous enough, while others may be more concerning.
According to Dr. Abraham, you’ll want to visit your MD if and when:
- You need to change your pads/tampons every hour or two while menstruating
- Your menstrual cycle lasts longer than 7 days
- Your menstrual pain can’t be managed with OTC meds like Motrin or Tylenol
Penn Medicine adds that you should seek medical intervention if you haven’t had your period within the past 90 days.
Of course, you can always discuss any more mild changes with your menstrual cycle during your annual OB-GYN visit and see if any interventions are necessary.
The Takeaway on Irregular Periods
There’s a pretty sizable window into what a normal period can look like from one woman to the next. However, if your menses deviate significantly from your own usual—namely if you bleed heavily, have a period that lasts longer than a week, or if painful symptoms suddenly arise or worsen—your best bet will be to consult your medical provider.
For less severe cases—say, if your period and/or cycle length deviates by a day or two or it seems to be getting lighter—you don’t need to stress yourself out. Slight changes aren’t a major cause for concern. Yet if they’re accompanied by other signs of feeling worse for wear, Dr. Abraham says a little extra TLC will do your menstrual health and overall well-being some good.
To promote period regularity, she advises keeping your stress under control. Her go-to recommendations include getting enough rest, plus relaxation techniques such as yoga and acupuncture. “These can only help, as well as maintaining a healthy diet and exercising moderately,” she shares. While the advice isn’t game-changing, it’s tried and true to keep your mind, body, and hormones healthy, happy, and harmonious.
Should you need some extra support to relieve PMS symptoms (think: hormonal acne, bloating, mood swings, discomfort, and breast tenderness), you might want to check out a hormonal support supplement like HUM’s SOS PMS gummies. Chasteberry helps provide PMS relief and vitamin B6 promotes a balanced mood. All the while, cranberry adds a little something extra for urinary tract support.