When it comes to taking care of our health, asking questions never hurts. But is it always worth a visit to your doctor? We’re asking experts to weigh in on your burning questions—from feminine to general health and everything in between—so you can get advice from a pro before you go. The doctor will see you now.
Your period can tell you a lot about your health—especially when your monthly cycle isn’t all that it should be. But how do you know when an irregular cycle is a problem? We asked resident expert Dr. A. Nicky Hjort, M.D., OB-GYN, about when an irregular cycle is cause for concern.
Q. What makes my cycle ‘regular’ or ‘irregular’?
According to Dr. Hjort, “regular” cycles can be defined by “mosts.” Most of the time you have a cycle about every twenty-eight days, with twenty-one to thirty-five days considered a typical range. Most of the time your flow lasts three to five days, soaking a pad or tampon—but not both—every two to three hours. Most of the time, you have a day or two of heavier flow.
These guidelines leave room for each woman’s normal variant, so don’t get nervous if you don’t experience the exact same thing every month.
Cycles that are irregular, or in clinical terms, “abnormal,” are “longer than thirty-five days or shorter than twenty-one days,” Dr. Hjort says. It’s also considered abnormal to have bleeding occur throughout the majority of the month or very rarely.
Q. Does an irregular cycle mean there’s something wrong?
Dr. Hjort says the pattern of irregularity is what indicates whether your situation is annoying or serious. Your cycle could change due to stress, nutrition, extreme weight loss or gain, taking a new medication, or stopping a medication, among other life changes.
If you once had regular cycles and have noticed a change that one of these situations can’t explain, it’s time to see your doctor in person. You won’t be alone: The majority of visits to the gynecologist are prompted by atypical bleeding.
Q. Could my irregular period be genetic?
While issues like uterine fibroids (tumors) and endometriosis can be genetic, most causes of cycle irregularity are hormonal. Dr. Hjort says these include thyroid dysfunction, polycystic ovary syndrome (PCOS), anatomic lesions, abnormality in the smoothness of the uterine cavity, and inflammation from infection.
To start sleuthing what’s going on in your system, the first step is tracking the duration and timing of your cycle with a good old-fashioned calendar or an app on your phone. When you visit your doctor with this information in hand, she will likely recommend a physical exam, a Pap smear, and blood tests to get a read on your hormone levels.
If more information is needed, Dr. Hjort suggests you may have an ultrasound to look for polyps or tumors. If there has been a significant change in the timing or quality of your cycle, it’s possible that the cause is uterine, cervical, or hormonally active ovarian cancer.
The good news is that once you find out what’s going on, you can take action to treat it, whether that means a change in diet, increasing supplements, finding time to exercise more, or medical treatment.
Q. Can a doctor help regulate my cycle?
Lifestyle changes in eating well, exercising regularly, and maintaining an ideal BMI will make a noticeable difference for some women. “Every pound, every percent over their ideal body weight, the cycle gets heavier and the cycle gets longer,” Dr. Hjort says. As mentioned above, sleuthing into your hormonal activity can provide a doctor with more information to solve underlying issues.
To ameliorate significantly bothersome symptoms and regulate cycles more quickly, your doctor may suggest taking birth control pills. Dr. Hjort says this course of action can give the most rapid results, i.e., a 20 to 30 percent reduction in symptoms such as pain, length, and heaviness of cycles even on the first cycle after beginning the regimen. This course of action, however, shouldn’t be taken lightly. The catch is that the Pill does not fix underlying causes. “There is much we still don’t understand about women’s reproductive health and infertility,” said Dr. Elizabeth Jensen, Ph.D., in a recent Verily article. “For example, why some women experience endometriosis or why some couples experience infertility.” If left untreated, conditions such as endometriosis and PCOS contribute to infertility or subfertility. A thorough study of your history, general exam, and hormone tests could clue your provider into a variety of root issues and the best next steps.
Your cycle should be a reminder of what your amazing female body is capable of. When it’s not operating at its best, it’s only because your body is trying to tell you that something’s not right.
We are more than the sum of our parts. Taking care of your feminine health is an important element of being the very best version of your whole self.
Photo Credit: Eleanor Rask