What Causes Irregular Periods?

For some women, there’s nothing more distressing than having irregular menstrual cycles.  If you are sexually active and not having regular periods, that can send you up the wall wondering if you are pregnant every month. 

For others, it seems to be the most convenient non-issue.  The less you have to wear a tampon or pad for a week out of each month, the better, right? So why bother the doctor about it.

The problem with this approach is that women who shed their endometrium irregularly may have a higher risk of endometrial cancer in their lifetime. When the lining of the uterus keeps building and building without shedding, it can have the potential to get out of control and become cancerous.  So if you suffer from irregular periods, it’s really important to figure out the root cause and treat it. 

What are some of the most common causes?  Let’s find out. 

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What Is a Normal Menstrual Cycle?

Periods can vary from woman to woman and there’s broad range of what’s considered “normal.” So before we can understand what is abnormal, we need to define the parameters of what is actually normal:

• Age range. Most women start getting their periods, a term referred to as menarche, sometime between ages 9 and 15. If menarche does not occur in this age range, then this is considered abnormal. 

• Cycle. A cycle is defined as the number of days between the first day of your bleeding until the first day of your next period. A normal cycle can range anywhere between 21 and 35 days. 

• Duration. Normal periods have a duration of 2 to 7 days. 

• Flow. The amount of bleeding, or flow, can be quite variable for different women. However, if you notice a significant change in the amount of flow compared to your previous periods, it could be a sign of abnormality.  But I would say most women report changing through about 4-5 tampons or pads on a typical heavy day.

What Can Cause Irregular Periods?

There's a myriad of potential causes for irregular periods.  Here are 7 of the most common culprits that can send our cycles haywire:

1. Pregnancy.  Pregnancy is by far the most common cause of a missed period. As obvious as it may seem, it can be easily missed, even at the doctor’s office. As a side note, just because you don’t get your periods (as in women who are breastfeeding, or those who simply always have irregular periods), it doesn’t mean you can’t get pregnant. Shedding your uterine lining doesn’t always go hand-in-hand with ovulation.

2. Stress. Sure, we tend to blame a lot on stress these days. However, there really is a physiologic phenomenon called Hypothalamic-Pituitary Syndrome, a term referred to the absence of periods due to hormone changes in the brain that tell the female body that you are too stressed out to have a baby. And when that happens, your periods will stop in response.

3. Eating disorders. Anorexia or bulimia also tell the brain that you are not healthy enough to carry a pregnancy, thereby shutting down your periods.  See also: Do You Have a Body Image Disorder?

4. Vigorous exercise. Exercise is great for our hearts and our bodies. However, like anything you do in excess, it may do more harm than good.  Sometimes serious athletes begin to experience problems with menstrual periods because of over-training.

5. Polycystic Ovarian Syndrome (PCOS). This is a common health condition that causes excess body hair, weight gain, acne, and problems with periods.  This is one of the top causes of irregular periods in young women.  Make sure to listen to my prior episode on this topic for tips on how to diagnose and treat PCOS.

6. Hormonal conditions. Besides PCOS, there are a few other less common health conditions, such as thyroid disorders and disorders that cause an elevation in the hormone prolactin, that may cause irregular periods. These disorders can often be screened through a blood testat your doctor's office.

7. Medications. Birth control, steroids, or antipsychotic medication can also cause our periods to go out of whack.  Make sure to review your medication list with your doctor.

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Please note that all content here is strictly for informational purposes only.  This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider.  Please always seek a licensed physician in your area regarding all health related questions and issues.

Woman in pain and birth control pills images courtesy of Shutterstock.