Periods are not necessarily the most comfortable part of a woman’s life. But sometimes, abnormalities such as an irregular cycle length or severe pain can cause significant disruption to a woman’s life.

How do you know if your cycle is considered normal? And when is it time to seek more help?

What is normal?

In general, a cycle of 28-30 days is typical for women, explains OB-GYN Dr. Beverly Alten. “Of course, everyone is different,” Dr. Alten says. “Women don’t need to be concerned about variations in their cycle unless their periods are closer than three weeks apart or longer than three months apart.”

A certain amount of irregularity is still considered normal. Women may get their period anywhere between four and six weeks apart. “Even if periods are two months apart, but you’re still ovulating, it’s okay,” Dr. Alten explains. “As long as you’re not trying to get pregnant. But if periods are occurring every two weeks, that can be a disruption for women.”

Understanding symptoms

If a period lasts for more than 10 days, or if women have to change a tampon every one to two hours for longer than a day or so, these are also signs of irregularity. “If you have severe cramps, cramping between periods, or extreme PMS symptoms, those can all be addressed with your OB-GYN,” says Dr. Alten.

Irregular symptoms can point to underlying conditions. In some cases, women may have a thyroid disorder. In other cases, the underlying issue may be an overproduction of prolactin, the hormone the brain produces when a woman is breastfeeding. “We always start with checking hormone levels, and of course, always rule out pregnancy,” says Dr. Alten. “There’s also a possibility of uterine polyps. In the case of severe cramping, there could be a diagnosis of endometriosis or adenomyosis.” However, women need to understand that, sometimes, none of these underlying conditions are at play, and treatment will focus on symptom relief.

Treatment options

“Because irregular periods are often secondary to irregular hormone fluctuations, the first line of treatment is usually oral contraceptives, intrauterine devices (IUDs), implants, or another form of treatment to help regulate hormones,” explains Dr. Alten. “Hormonal treatments don’t necessarily cure any underlying problems, but something as simple as the birth control pill can provide significant relief for irregular or heavy periods.”

If women are done childbearing, they may also consider endometrial ablation or, in some cases, hysterectomy.

When to see a doctor

There’s no one-size-fits-all for defining a normal period. But if cycles are closer than three weeks apart, from day one to day one, or longer than three months apart, schedule an appointment with an OB-GYN. A women’s health care provider can also offer treatment options for heavy bleeding, pelvic pain, or severe cramps.

“Most of the time, period irregularities are not caused by an underlying condition. Rather, it’s usually a hormonal issue,” explains Dr. Alten. “Although hormonal problems can’t be cured, they can be controlled. You don’t have to suffer through your symptoms.”