It’s bad enough dealing with your period once a month – the cramps, the mood swings, the ruined underwear… But twice?
As it turns out, getting your period twice in one month isn’t all that abnormal. “The average cycle should occur every 21 to 35 days and last anywhere from two to seven days,” explains Dr Lakeisha Richardson, an obstetrician-gynaecologist based in Greenville, Mississippi.
So if you’re on the shorter end of that spectrum, that math could easily translate into getting your period twice in one month. And about 40 to 60% of women will have some irregular periods throughout their lives, she says.
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 Dr Alyssa Dweck, an obstetrician-gynaecologist 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 contraception injection will always cause irregular bleeding,” says Dr 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.
Read more: 11 reasons why your period is suddenly lasting forever
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 Dr 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 Dr Richardson.
Obviously, this can be ruled out with a simple pregnancy test. But try not to wait too long: Dr Christine Masterson, 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 tumours 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 Dr Dweck, especially if they are touched, like during sex, and “fibroids can cause pain, back pain, abdominal bloating, anaemia, pain with intercourse and spontaneous bleeding because they’re not associated with the menstrual cycle,” explains Dr Richardson.
Head to your obstetric-gynaecologist 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 Dr 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.
Read more: Is there a way to make your period come faster?
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 Dr 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 eight and 20% 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 oestrogen, progesterone and testosterone,” Dr 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 tumour growing on the cervix or uterus can bleed erratically,” says Dr 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 obstetric-gynaecologist STAT.
Read more: This explains why you get clots in your period blood
8. You’re seriously stressed out.
High levels of stress can cause either more frequent periods or completely missed ones, says Dr 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 Dr Masterson.
9. You’ve been travelling recently.
If you get back from a holiday and find an earlier-than-expected period welcoming you home, you might be able to blame said holiday on your irregular bleeding. Depending on how far from home you went, excessive travelling 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 Dr 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 Dr 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 gynaecologist has confirmed that’s what’s happening.
Read more: What every woman should know about using scented tampons and pads
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,” Dr 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 doctor – 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.
This article was originally published on www.womenshealthmag.com
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