A “Regular Cycle:” It’s All Relative

| Posted On Feb 26, 2013 | By:

3 WomenTalking about irregular periods first requires establishing what is and is not “regular.” When asked how long a woman’s menstrual cycle should be, most people would answer 28 days. But that’s just an average – very few women have 28 day cycles, and fewer still have 28-day cycles every single month, time and time again.

For most women, cycles run anywhere from 21 to 34 days, so defining regularity needs to be defined in terms of what is right for you. If you regularly get your period every 26-28 days and then go 33 days, that’s irregular for you. This irregularity may not be of concern, especially if it only happens once, or it may be an indicator of something that needs to be checked out by your doctor. Below, I’ve outlined some common causes and conditions that can impact adolescents and women at different stages in their lives.

Most girls start getting their periods between the ages of 10 and 15. It’s not unusual, especially in the first 2 years after menarche (the first period), to skip periods or to have an irregular menstrual cycle. A bad illness, rapid weight change, or stress can also make your cycle irregular. Some teens may also develop irregular periods — or stop having periods altogether — as a result of certain medications, excessive exercise, very low body weight, or not eating enough calories.

If your periods have not settled into a fairly predictable pattern by the time you’ve been having periods for 3 years, it might be a good idea to speak with your doctor and discuss whether something else is going on.

Just like for teens, illness, certain medications, stress, and quick weight changes can affect a woman’s cycle, too. Sometimes, a hormonal imbalance might be the culprit. Your cycle can be affected if you have hyperthyroidism or hypothyroidism, which means that your thyroid gland is producing too much or too little hormone, respectively. Luckily, these conditions can be easily treated.

Another hormone imbalance that causes irregular periods is called polycystic ovarian syndrome or PCOS, which is also accompanied by excessive levels (all women have some) of the male hormone androgen. PCOS can also cause severe acne, muscle mass, and excess facial hair and is the most common cause of infertility in women; therefore, if you want to have a baby and have irregular periods and/or any of the above symptoms, you may wish to see your doctor.

By the time a woman has reached her 40’s, her period should be pretty predictable, but then, it might start to be not so regular. What’s going on?

Although most people think about menopause affecting women in their 50s, the reality is that, usually in a woman’s 40s, her ovaries gradually start to produce less estrogen, a stage known as “perimenopause.” Perimenopause lasts for an average of four years, but can last as long as ten years. Many of the symptoms people associate with menopause, including irregular periods, also happen during perimenopause.

For many women, “irregular” during this time usually means a longer cycle and possibly a lighter period when it comes, but for some, their cycles may come closer together or their periods may be heavier; actually, any change to frequency and/or severity of the menstrual cycle is possible. During perimenopause, women may also experience stronger or more numerous symptoms of premenstrual syndrome (PMS).

Regardless of your age, you should see your doctor if you start having periods that last longer than 7 days, are heavy, are occurring more often than every 21 days or less often than every 45 days, or are accompanied by severe cramping or abdominal pain. Also let your doctor know if you have bleeding in between your periods.

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About Dr. Denise Morin

Dr. Denise Morin is a board-certified obstetrician and gynecologist and is a fellow of The American College of Obstetrics and Gynecology. She practices at Harvard Vanguard Medical Associates in Quincy, MA and is affiliated with Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, and Faulkner Hospital. She received her medical degree from Boston University School of Medicine and completed her Obstetrics and Gynecology residency at Beth Israel Deaconess Medical Center in Boston, MA. Dr. Morin enjoys caring for women of all ages. Her professional interests include prenatal care and preconception counseling, abnormal pap smear management, abnormal uterine bleeding, and contraception. When she is not at work, she enjoys spending time with her husband and two children, cheering on Boston sports teams, and traveling.

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