But if you're part of that (pretty unlucky) group,
know this: “Irregular bleeding can have different implications depending
on age, medical history, and family history,” says Alyssa Dweck, M.D.,
an ob-gyn and author of The Complete A to Z for Your V. “So it’s important to seek ob-gyn guidance if you have persistent, recurrent, or worrisome bleeding habits.”
Even
though most of the reasons are totally benign, seeing your doctor can
help identify the cause. Here's what might be going on—and what to do to
get your cycle back on track.
1. You forgot to take your birth control.
Duh,
right? “Missing birth control pills or forgetting your Depo-Provera
shot will always cause irregular bleeding,” says Richardson. “Anytime
you fail to take a birth control method correctly, you will bleed
because you have an abrupt withdrawal of hormones.” This kind of
bleeding, though, is not an emergency. “
If you resume your birth control
by following the instructions, the bleeding will subside, she says.
Just make sure to use a backup method of birth control to prevent
pregnancy until your next period.
2. You're pregnant.
I know: Pregnancy means missed periods. But “believe it or not, some women will bleed irregularly if they are pregnant,” says Dweck. Spotting during pregnancy
is very common, especially in the first trimester, and can occur for a
number of reasons, including after heavy exercise or sex, or due to
polyps (benign lesions that can grow inside the uterus or cervix and
bleed spontaneously), says Richardson.
Obviously, this can be ruled out with a simple pregnancy test.
But try not to wait too long: Christine Masterson, M.D., chief of the
women and children’s service line at Summit Medical Group in New Jersey,
warns that ectopic pregnancies
(i.e. when an egg implants outside the uterus) may also cause irregular
bleeding and can turn into a life-threatening emergency if left
untreated.
3. You have uterine polyps or fibroids.
Uterine
issues like polyps or fibroids—benign lesions or tumors that can grow
in the uterus—are very common and may be related to hormonal issues.
“Uterine polyps can cause bleeding in between periods,” says Dweck,
especially if they are touched, like during sex, and “fibroids can cause
pain, back pain, abdominal bloating,
anemia, pain with intercourse, and spontaneous bleeding because they’re
not associated with the menstrual cycle,” explains Richardson.
Head
to your ob-gyn for an ultrasound, a uterine biopsy, or a hysteroscopy
(a scope that looks into the uterus). “Removal of the growths is usually
curative and ensures that there are no other causes of irregular
bleeding,” she says.
4. You have an infection down there.
Vaginal
and cervical infections are incredibly annoying for a number of
reasons, not least of all that they can cause bleeding outside of your
period. “Inflammation or infection of the cervix with bacteria such as bacterial vaginosis or trichomoniasis can cause irregular bleeding,” says Richardson.
“Infections
should be treated immediately, because research has shown that sexually
transmitted disease such as trichomoniasis increases your risk of
contracting HIV and other STDs," she says.
5. Your thyroid isn't working properly.
An
underactive or overactive thyroid gland can cause your period to come
twice in one month. “The thyroid gland is regulated by hormones produced
and regulated in the same area of the brain—the pituitary and
hypothalamus—as the hormones that control menstruation and ovulation,”
explains Dweck. “When one is off, the other might be affected.”
This is diagnosed with a blood test and typically treated with medication.
6. You have PCOS.
Polycystic ovarian syndrome is a hormone imbalance that affects between 8 and 20 percent of women, according to the National Institutes of Health.
“It’s a result of less frequent ovulation or the lack of ovulation,
leading to an imbalance of estrogen, progesterone, and testosterone,”
Dweck explains. “One of many symptoms includes irregular bleeding.”
Other commonly associated symptoms include acne,
difficulty maintaining weight, hair growth in places typical to men
(like the upper lip or chin), and fertility issues, she says. If you
think there's a chance you have PCOS, schedule an appointment with your
doc to be evaluated.
7. You have precancerous or cancerous cells.
When
found in either the uterus and cervix, precancerous and cancerous cells
can cause irregular bleeding. “Suffice it to say, a tumor growing on
the cervix or uterus can bleed erratically,” says Dweck. One study even found that irregular periods are more likely to lead to ovarian cancer, so early detection is key.
These are diagnosed with an ultrasound and uterine biopsy, and a pap smear and cervix biopsies, respectively, so if you’ve ruled out other causes, get to an ob-gyn STAT.
8. You're seriously stressed out.
High
levels of stress can cause either more frequent periods or completely
missed ones, says Masterson, because the hormones that trigger your
ovaries to ovulate every month originate in the brain (you know, the
same place where stress starts).
Basically, when you’re swamped at work or worrying about relationship drama (especially if it’s causing you to get less sleep
at night), those hormones can misfire and affect your cycle in negative
ways. If you know you’ve been mentally stretched to the limit lately,
consider doing some yoga or meditation exercises, or talking to someone who can help manage your stress. You’ll be surprised how much it can help your mind and body, says Masterson.
9. You've been traveling recently.
If
you get back from vacation and find an earlier-than-expected period
welcoming you home, you might be able to blame said vacation on your
irregular bleeding. Depending on how far from home you went, excessive
traveling can disrupt your period.
“Interfering
with your circadian rhythms, like changing time zones or working night
shifts, can cause changes in the hormones that trigger your cycle,” says
Masterson. As long as the travel was a one-time thing, this should
resolve on its own. If you work the night shift regularly, though,
irregular periods might be your new normal.
10. You're in the early stages of menopause.
Perimenopause,
which can start as early as your mid-thirties, can cause irregular
periods, including ones that are more frequent and heavier than usual,
says Masterson.
There’s not much you can do
here (you’ve got to let nature run its course), but there are ways to
ease the overall effects of perimenopause, like medications or other
therapies, if your OB has confirmed that’s what’s happening.
11. You've gained a lot of weight.
Rapid
weight gain or loss and excessive amounts of exercise can also affect
the hormones that stimulate ovulation, changing the typical pattern of
your cycle.
“Usually if you are doing extreme exercise or have
gotten underweight, your body turns off the ovulatory process—it thinks
it’s in a famine situation, and that’s not a great time to have a baby,”
Masterson explains. “But if you’ve become extremely overweight, you
might see irregular bleeding happening more or less frequently than
normal.”
If you think your weight might be to blame for your irregular periods, check in with your doc—it’s possible that there are external factors, like a medical condition or new medication, contributing to your weight gain that would be worth looking into.
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