Irregular periods: What to look out for and how to manage them

What is an ‘irregular’ period?

An irregular period is when the gap between the last day of your previous period and the first day of your current period is less than 21 days (unusually close) or more than 35 days (unusually far apart). Your period is also considered irregular if there is significant variation between each of your cycles. Most people’s periods are relatively predictable. If yours are not, you probably have irregular periods.

It can happen to anyone who gets a menstrual period and is quite common. There are many things that can cause periods to be irregular.

What are the signs that my periods are irregular?

Everybody’s periods are different, so what is ‘normal’ for you may not be the case for others. 

However, signs that your periods may be irregular and need further investigation include:

• The number of days in between each of your periods is different and keeps changing
• Changes in the amount of menstrual blood from one period to the next
• Your periods occurring closer together – less than 21 days from the start of one to the start of the next one
• Your periods occurring further apart – longer than 35 days between the start of one and the next one

What causes irregular periods?

Occasionally having an irregular period usually isn’t a cause for concern, as it can often happen due to factors such as hormonal changes caused by taking contraception, changes during puberty, stress, overexercising, being ill, sudden weight gain or loss, or breastfeeding.

However, if your periods continue to be irregular, this could be a sign of an underlying health condition, or an indication that elements of your lifestyle may need to be changed. Things such as chronic stress or weight concerns can cause irregularity.

Common conditions that can cause your periods to be irregular include:

Polyendocrine metabolic ovarian syndrome (PMOS, formerly known as PCOS)

Polyendocrine metabolic ovarian syndrome (PMOS) can cause irregular periods as the condition causes high levels of hormones called androgens, such as testosterone, to be produced. This can disrupt ovulation, as high androgen levels prevent your ovaries from releasing eggs.

Endometriosis

The main symptom of endometriosis is irregular periods. This is because abnormal endometrial tissue grows outside of your uterus and often attaches itself to your ovaries or fallopian tubes. This tissue reacts to monthly hormone changes, causing bleeding, swelling, and irritation to nearby tissues at the wrong time.

Thyroid or pituitary gland disorders

An imbalance in your thyroid hormones can cause a disruption in your menstrual cycle. If your levels are too high or too low, they can throw off the regular production of reproductive hormones, leading to irregular periods.

Perimenopause

As you transition into menopause, you will first pass through the perimenopause stage. During this time, your ovaries will begin to produce less hormones, causing your periods to become more irregular.

This process is typically natural (although can happen as a result of intense treatment such as chemotherapy) and starts to happen around your mid-40s but can occur as early as your late-30s or as late as your mid-50s.

Uterine or ovarian cancer

In rare cases, certain gynaecological cancers, such as ovarian or uterine cancer, can cause your period to become irregular.

Ovarian cancer can cause issues with periods because, as cancer develops on the ovaries, this can disrupt the production of hormones such as oestrogen and progesterone. Irregular periods are a less common sign of ovarian cancer, although still an important sign to look out for.

Uterine (womb) cancer can cause irregular periods due to tumours growing in the uterine lining (endometrium), leading tissue to thicken, become fragile, and bleed irregularly. Irregular periods are a common early sign of uterine cancer, so it is advised to visit a doctor about your symptoms to investigate your condition further.

Treatment options for irregular periods 

There are a wide range of options to help treat irregular periods. Treatment will depend on what is causing the issue.

Lifestyle changes

Ensuring you maintain a healthy lifestyle can greatly improve your symptoms and prevent irregularities in your cycle.

Making sure you are a healthy weight, partaking in regular exercise, lowering your stress levels, and eating a nutritious diet can help keep your hormones balanced – which can help your periods become more regular.

Implementing these changes may be enough to help regulate your periods on its own. However, this isn’t the case for everyone. Keeping healthy generally, especially alongside other forms of treatment, can help improve your wellbeing and improve your chances of seeing successful recovery results.

Medication

Alongside lifestyle changes, medication is typically the first form of treatment recommended to help regulate your cycle.

Some options include:

• Hormonal birth control, either in the form of pills, a vaginal ring, injections, or an IUD (intrauterine device)
• Tranexamic acid
• Metformin
• Progestin therapy
• Hormone therapy
• Antibiotics (if there is an infection)

The type of medication you receive will depend on the issues that your doctor is trying to target. For example, hormone therapy may be recommended to patients who experience irregular periods due to perimenopause.

Surgery

If medication and lifestyle changes are ineffective, depending on what is causing your irregular periods, your doctor may recommend surgery. 

Surgical options include:

• Endometrial ablation – a procedure that uses heat, cold or different types of energy (such as microwaves) to destroy the tissue that lines your uterus
• Myomectomy – a procedure done to help remove fibroids from your uterus
• Hysterectomy – a procedure done to remove your entire uterus and sometimes your cervix, ovaries, and fallopian tubes

Your doctor will discuss all your available options and whether you want to get pregnant at any point in the future before going forward, as some procedures may affect your ability to have children.

When should I see a doctor about my irregular cycle?

If you are worried about your periods being irregular and want to further investigate the issue, you should consult with a medical professional about your concerns.

It is important to seek medical advice if you also have the following symptoms alongside irregular periods:

• Bleeding or spotting between periods or after sex
• Extremely heavy periods, where you need to change your tampon or pad almost every hour, or you have to wear both a pad and a tampon at the same time
• Heavy bleeding that leaks onto your bed or through your clothes 
• Periods that last longer than seven days
• High fever
• Dizziness
• Severe pain
• Vomiting and nausea

Your doctor can discuss what next steps to take and whether you may need further investigations to determine whether you may have an underlying condition.

Frequently asked questions

How many days are there between menstrual periods?

Typically, for the average period, the number of days between each period is usually about 28 days. However, a healthy cycle can range from 21 to 35 days.

When is a period considered late?

Your period is considered late if you're 7 days past your expected due date. If your period hasn’t arrived after 6 weeks, you can consider your late period a missed period.

Why have my periods completely stopped?

If you haven’t had a period for over 3 months and you’re not pregnant, this is known as paused or missed periods (secondary amenorrhoea).

It’s important to seek advice from your doctor regarding missed periods as this can be a sign of an underlying health condition.

Missing periods can also be a sign of pregnancy, so it’s advised that if you are sexually active, you seek out a test to confirm whether this is the case.

Private period and gynaecological care with Circle Health Group

If you are concerned about irregular periods and want to investigate further, visit a gynaecologist at your local Circle hospital.

A consultation with an experienced gynaecologist is often the quickest and simplest way to diagnose what is causing the issue with your periods. They can also talk with you about the best treatment options for your specific situation and provide lifestyle management advice to help ease symptoms.

Book an appointment with one of our experienced specialists by either calling us directly or using our online booking system.