Most women, between the time of their first period and menopause, have menstrual cycles approximately every 28 days. However, menstrual cycles that are irregular, or more or less frequent than the average cycle, are actually quite common. In fact, as Michael McCullough Jr., MD, OB-GYN with Kettering Physician Network Women’s Health notes, “Abnormal bleeding is the reason for about a third of gynecological visits.”
Disruptions to your cycle
“The most common causes of abnormal bleeding that I see are related to stress on the body: physical, emotional, environmental, spiritual,” says Dr. McCullough. Drastic weight loss or gain, changes in eating habits, or emotional upheaval can all affect menstrual cycles. “For patients who have missed their period for more than three months and are not pregnant, we should begin a work-up on their endocrine status.”
Dr. McCullough explains that, while abnormal bleeding is rarely life-threatening, it can greatly affect a woman’s quality of life. Dr. McCullough advises women to schedule an appointment with their gynecologist if periods stop for more than three to four months, if periods are abnormally heavy, or if they last more than seven to 10 days. Other signs of needing to see a gynecologist include suffering from extreme period symptoms such as severe pain, fever, vomiting, or menstrual migraines, or having a cycle that is less than 21 days or greater than 35 days.
What are the causes?
“In reproductive years, a missed period can be a sign of a ‘happy mistake’ if a woman is trying to get pregnant. If a woman is on birth control and not trying to get pregnant, it could be related to her contraception or medication.” Dr. McCullough shares that reasons for abnormal bleeding are individualized and are usually only highly concerning or dangerous in post-menopausal women, as abnormal bleeding at that age can be a sign of uterine cancer.
Some other conditions that can cause irregular periods can include polycystic ovary syndrome (PCOS), thyroid conditions, endometriosis, or uterine fibroids. Another common cause of irregular bleeding is having a body mass index (BMI) that falls into the overweight or obese category. Women who are overweight often have an abnormal ratio of estrogen and progesterone, causing periods to be absent or irregular.
How can I get back to normal?
“Treatment is based on a woman’s goals,” says Dr. McCullough. “For some patients, it can be as simple as adjusting medication or birth control options. For example, perhaps a patient’s intrauterine device (IUD) is wearing out or not in the right placement area. Other treatments include lifestyle changes, stress management, or other holistic approaches.”
“In all cases,” says Dr. McCullough, “there’s rarely a problem with increasing both aerobic and anaerobic exercise, watching your diet to meet nutritional needs, and making sure your emotional and spiritual needs are met. Not working on these aspects of your health raises your chances that you will be ‘playing catch up’ to treat health problems, as opposed to preventing them.”
Schedule an appointment with a Kettering Health Network OB-GYN to discuss any menstrual irregularities and find treatment options for relief. Visit ketteringhealth.org/obgyn to find a gynecologist near you.