Common Causes of Irregular Periods

If we could communicate one thing to all of the women out there it is this:

“Irregular Periods Are Never Normal!”

Having irregular periods means you’re ovulating sporadically (or not at all). In addition to potential health issues that need to be addressed, skip periods may make it harder to conceive when you’re ready to start a family.

We can’t tell you how many patients come to us and, as we make our way through the beginning stages of their initial infertility workup, they say, “Well, I never really had my period every month.” Or, “Yeah, really only have my period every few months or so.” Or, “My PMS and periods have always been horrible/heavy/painful/debilitating.” Yet, there’s no record of that in their charts because they’ve always said everything was just fine.

Women should mensturate regularly once they’ve made their way into full-blown puberty. While you may skip a few in the first several months or the first year or so, healthy reproductive systems settle into a monthly rhythm.

This means your period should start every 21 to 40 days (with 28 days being the average). Most women bleed between four to eight days.

You should always schedule an appointment with your gynecologist to evaluate potential causes if your period is finicky, intense, more painful than your peers’ periods, causes you to miss school or work, lasts shorter or longer than the number of days cited above, or you are prone to spotting in between cycles.

7 Common Causes for Random or Irregular Periods

The following are seven common causes for irregular, random, or unusual periods that have nothing to do with:

1. Endometriosis

We’re starting the list with endometriosis, one of the most common causes of female fertility in the U.S. It is diagnosed when endometrial cells (the cells forming the uterine lining) that nourishes a developing fetus and is shed each cycle when an egg isn’t fertilized.

Sometimes, this endometrial lining begins growing outside of the uterus on surrounding pelvic/abdominal tissues. When it’s time to shed the lining, the extra inflammation and work required for the body to shed the cells located outside of the uterus can lead to intense cramping, bloating, clotting, and heavier periods. It’s also a common cause of spotting.

2. Polycystic Ovarian Syndrome (PCOS)

Here’s another common cause of female infertility. PCOS often goes undiagnosed for far too long – especially for women who have “skinny” or atypical PCOS.  With polycystic ovarian syndrome, a combination of excess androgens (male hormones) and insulin resistance correlate with reproductive hormone imbalances that prevent ovulation.

Women with PCOS commonly skip periods or hardly ever have them. Other symptoms include:

  • Multiple ovarian cysts (as the name implies)
  • Male hair patterns (thin hair on top, excess hair elsewhere on the body such as the face, chest and back)
  • Darker patches of skin/moles – especially on the neck, under the arms, and torso
  • Excess weight in the middle and a tendency to be overweight (apple shape)
  • Moodiness and depression
  • Sugar cravings
  • Difficulty losing weight no matter how hard you try (due to insulin resistance)

Some women with PCOS are successful at managing their condition with natural lifestyle changes, others benefit from those same lifestyle and diet recommendations combined with Metformin and/or other methods to regulate blood sugar methods.

3. Exercising Too Much (or being too thin)

While mild- to moderate exercise is encouraged every day, too much exercise isn’t good for you. Women who have extreme exercise routines put their body into a non-ovulatory state, which also means less frequent periods or an absence of periods altogether.

Rather than your weight, we recommend paying attention to your body mass index (BMI). A healthy BMI is between 25 and 29.9. If your BMI is less than that and you have irregular periods, you should speak to a physician.

4. Fibroids or Uterine Polyps

Fibroid tumors (almost always benign) are not uncommon at all. In fact, we think that as many as 80% of women have fibroids at some point in their life, and most never even know it. They emerge and shrink or disappear, typically in cycle with estrogen levels. However, depending on their size, shape, and location, some fibroids cause problems.

These issues range from physical discomfort or a distended pelvis/abdomen to heavy bleeding, bleeding between periods and periods that last longer than normal. Tumors or polyps that encroach on the interior uterine space can compromise the implantation of a fertilized egg or cause a miscarriage (or complications) when a developing fetus runs out of space to grow.

5. Pelvic Inflammatory Disease (PID)

PID is one of the most common sexually transmitted diseases. Sometimes it is asymptomatic, other times it lets itself be known via fever, pelvic discomfort, painful urination, unusual discharge, etc. It can also cause irregular periods.

Because PID can lead to scarring and obstructions that cause infertility, it’s important to know if you have it – or if you have had it in the past – so we can evaluate whether it’s left a compromising mark on your reproductive system.

6. Stress

Just as too much exercise and a low BMI can stress the body enough to compromise ovulation and fertility, so can stress. If you are caught in a stressful job, a stressful relationship, you are someone who experiences high anxiety – all can contribute to the body shutting down the reproductive system.

Establishing healthy lifestyle habits – good diet, exercise, and healthy sleep habits – as well as practicing stress management tools should help return things to normal.

7. Early menopause or low ovarian reserve

Unlike sperm, that are replenished daily in a healthy male, the female egg is produced in a woman’s body when she’s still in utero. The immature eggs you are born with are the only eggs you’ll ever have. When your egg reserves are winding down, you’ll enter menopause – usually in your mid-40s or so.

If you are born with low ovarian reserves, or go into early menopause ( periods stop completely before age 45 but are sporadic leading up to that point), you’ll start having irregular periods. If you want to have a child, you’ll need to speak to a fertility specialist ASAP. If you don’t, your OB/GYN will still want you to schedule an appointment to speak to you about the menopause process and ways that s/he can support you through the journey.

Do you have irregular periods and a desire to start a family? Schedule a consultation with OB/GYN Associates so we can establish the cause and create an individualized plan to bring you back into a healthy, reproductive cycle.