Some level of irregularity is normal and expected from the average woman's period cycle. The average is considered to be 28 days, but it's not uncommon to vary that number up or down; sometimes it might be 26 or 27, other times it might be 30 or 31. This is a normal range.
An ovulation cycle is considered abnormal when it is outside of this normal range. A cycle shorter than 21 days or longer than 35 is far enough outside of the average that it can have effects on both health and medical processes. This comes from data from the Office on Women's Health.
Does Irregular Ovulation Affect Pregnancy?
The simple answer is yes, an irregular cycle will affect pregnancy. It's still possible to become pregnant, but the timing may be difficult, and your body may not cooperate.
Additionally, an irregular period cycle may be an indication of an underlying disease or disorder that can make pregnancy less likely, impossible, or even dangerous.
Different Types of Irregular Periods
There are several different categories of irregular periods, each of which is characterized by different symptoms and may have different causes.
Amenorrhea is the lack of a menstrual period. It can be permanent, or it can be temporary. Missing a single period is not typically a cause for concern, and can indicate pregnancy or any number of menstrual disorders. Missing more than one, particularly in the absence of pregnancy, is possibly a sign of an underlying disorder.
If you've had Amenorrhea since puberty, there are several possible causes, such as gonadal dysgenesis, Turner syndrome, PCOS, androgen insensitivity, and congenital adrenal hyperplasia.
Conversely, if your Amenorrhea started more recently, after puberty and after successful periods, it may have other causes. These causes include PCOS, premature ovarian failure, early menopause, or excessive androgen.
Oligomenorrhea is the medical name for irregular periods with increased time between them, typically more than 35 days. In some cases this is an intended side effect of hormonal birth control. If you're not on hormonal birth control, this can be a sign of thyroid problems, diabetes, eating disorders, and some medication side effects. It's also not atypical from young women who are extremely physically active. This version of irregularity can also be a sign of PCOS.
Oligomenorrhea, unfortunately, can increase the risk for endometrial cancer and hyperplasia. Even if it's an intended side effect of medication, it's worth mentioning to your OBGYN to treat the condition.
Menorrhagia is a medical term for extremely heavy or prolonged period bleeding during periods. When cramps and blood loss are excessive enough to prevent normal, every-day life, it becomes a medical condition worth consulting a physician about.
There are a lot of different possible causes for this version of irregularity, ranging from polyps to hormonal imbalances, uterine fibroids, adenomyosis, cancer, and bleeding disorders. It can also be a sign of complications with pregnancy.
Metrorrhagia is a condition where you may have regular bleeding between periods, in addition to normal period bleeding. It also has a wide range of possible causes, including the above.
What Causes Irregular Periods?
As you can see, there are a lot of different possible causes for irregularity. Some of them are intended, like the effects of hormonal birth control. Some of them are benign, but many of them are dangerous or indicative of more dangerous conditions.
PCOS, or Polycystic Ovary Syndrome, is a common cause of irregularity and other menstrual disorders. When the female body secretes too many androgens – the ‘male' sex hormone – this can prevent mature eggs from being developed and released.
PCOS has a number of possible causes, but the exact causes and root issues are unknown. It is thought to be caused by excess insulin, low-grade inflammation, hereditary factors, and excess androgen.
In addition to irregular periods, PCOS can lead to infertility, pregnancy complications such as gestational diabetes, miscarriage, liver inflammation, type 2 diabetes, sleep apena, and other disorders. It can also lead to endometrial cancer.
PCOS can be treated but not cured. Treatment typically involves a combination of some medications and some lifestyle changes, including weight loss and a more active lifestyle.
Symptoms for PCOS include irregular periods, of course, but also weight gain, insulin resistance, high blood pressure, high cholesterol, excess hair growth, acne, and thinning hair.
Perimenopause is another possible cause for irregular periods. This typically affects women of middle age, beginning around age 47. This is the process of your body transitioning out of its fertile range and into menopause.
Symptoms of perimenopause include hot flashes, night sweats, moodiness, and of course irregular periods. In perimenopause, it is more difficult but not impossible to become pregnant.
Thyroid disease is a common cause of period irregularities. The period relies on estrogen to begin, and on progesterone to cease. The thyroid regulates these and other hormones, including androgen, which impact ovulation. If there is too much or not enough of one of these hormones at the proper times, periods will run haywire.
Thyroid disease can be either overactive or underactive thyroids, and can lead to a variety of different issues throughout the body.
Obesity is another common cause for irregular periods. Being overweight has a wide variety of effects on the body, most notably causing issues with hormones throughout the body. While diabetes is one of the most common side effects, irregular periods and PCOS can be caused by weight.
Conversely, being underweight can also disrupt the body enough to cause issues with periods. This is typically caused by an eating disorder, but can also be caused by other sources, such as malnutrition.
Stress can also lead to irregular periods. Stress-based irregularity typically affects the period closest to the stressful event, if such an event is the trigger. For overall generalized stress, it can lead to ongoing irregularity.
When Irregularity is a Cause for Concern
Some level of irregularity is natural, but at a certain point it may be cause for concern and you should consult with your doctor. At what point should you make that decision? It depends on your symptoms.
You should see a doctor if and when:
- Your periods are far outside the normal range; that is, under 21 days between them or over 35 days between them.
- You haven't had a period in over three months.
- You have menstrual bleeding that lasts for longer than seven days.
- Your bleeding is excessively heavy, such as soaking through a pad or tampon every hour or so, multiple times during your period.
- Your period is excessively painful such that it prevents normal daily activity.
- You have been attempting to become pregnant for over one year without success, while also being under 35 years old.
With regards to pain specifically, if your doctor downplays your concerns, it may be worth finding a different and more sympathetic doctor. There is an ongoing issue in the United States and in many places around the world with doctors who dismiss the concerns of women. If you feel you have a valid medical concern and you're being ignored, change physicians.
Dealing With, Treating, and Coping With Irregular Periods
Depending on your goals with managing your disorder, you may opt for symptom management, or you may try specific fertility treatments. Additionally, dealing with your irregularity will depend on which cause is leading to your disorder.
In many cases, the first and best thing you can do is lose weight. Bringing your body down to a more healthy body weight range can have a variety of beneficial effects. These range from better regulation of hormones to decreased risk of diabetes to better outlooks with pregnancy. Picking up a healthier lifestyle through diet, exercise, and health supplements can do a lot towards reducing the effects of menstrual disorders and improving your chances at pregnancy.
Some health concerns, like endometrial cancer, will have their own treatments. These can include surgery, radiation therapy, and other treatments. It's best to talk to your doctor if this is the cause of your disorder; don't get your cancer treatment advice from a random internet blog, please.
If you have an underlying thyroid disorder, you may be given thyroid medications to help control hormones. These can include synthetic hormones to help regulate your period, among other bodily effects. Again, talk to your doctor about this disorder.
Getting Pregnant with Irregular Periods
Since irregularity can affect fertility, if your goal is to become pregnant, you will need to take steps to increase the chances of becoming pregnant and of bearing a healthy child. Those steps can include:
Maintain a healthy weight and activity level. Obesity increases the risk of a wide range of possible complications with pregnancy. Being underweight can also cause issues with both fertility and pregnancy. Either way, maintaining a healthy weight is a huge benefit.
Take steps to reduce stress. While we can't always avoid stress in our lives, and certain extreme stress events are beyond our control – such as an auto accident – you can always take steps to reduce some common sources of stress. Getting enough sleep, eating healthy, reducing caffeine, maintaining a regular schedule, and other steps can help reduce day to day stress.
Record and predict your cycles. Anything from checking basal temperature to buying and using ovulation predictor kits can help you keep track of your cycles with more accuracy, which can then help you predict when you have sex to achieve pregnancy. It's also recommended that you have sex every 2-3 days to maximize your chances of pregnancy.
Consider fertility drugs. There are a bunch of different drugs offered for fertility problems. The most common drug is clomiphene, found under the brand names Clomid and Serophene, among others. It's a known, tested, and proven drug that helps increase fertility. It's a drug taken orally – most fertility drugs are shots – and can have a beneficial effect on women with menstrual issues.
Medications are not without their side effects, of course. Clomid is known to occasionally cause hot flashes, breast tenderness, bloating, and the occurrence of twins. Pregnancy with twins or multiples can be dangerous, so keep this risk in mind.
Alternatively or additionally, you can consider natural fertility boosters. There are a bunch of different natural herbs and plants that people have been taking for centuries to increase fertility. While these are not likely to have as strong and immediate an effect as fertility drugs, they can supplement those drugs, or they can be just the kick you need to get pregnant when you're on the edge.
Think about IVF. In vitro fertilization, or artificial fertilization, can be a valid and valuable treatment for many women with fertility issues. This is a possible option for women who want to become pregnant but have found that other treatments make their bodies hostile to sperm or that they cannot become pregnant the normal way.
Potential Issues with Pregnancy
As a final note, be aware that if you have irregular cycles, you may have other issues with pregnancy. Irregular cycles can indicate an underlying cause that also affects pregnancy. Women with irregular cycles who become pregnant are at higher risk for preeclampsia, preterm birth, gestational diabetes, and miscarriage.
If you become pregnant, it is worthwhile to talk to your doctor about your irregular cycles so they can keep an eye out for possible complications and treat them before they become major issues.