by Marcelle Pick, OB/GYN NP
Answers to your questions
To begin with, let me reassure you that most irregular periods are benign. Missed periods, too frequent periods, spotting, or bouts of heavy clotting and bleeding are usually caused by an underlying hormonal imbalance that is easily treated.
Most of us have missed a period at one point or another — some with anticipation of a pregnancy, others because of anxiety or tension. At the clinic, we see women who menstruate like clockwork, while others report never having had a regular cycle. One thing is a given, however – shifts in hormonal balance will alter whatever pattern a woman has experienced in the past. Such shifts are especially common in perimenopause.
What is an irregular period?
At the clinic we answer questions all the time about irregular periods. A textbook period happens every 24-29 days, but in truth what is “regular” covers a wide range. Cycles between 23-35 days are very common. A woman may get her period only one to four times a year. Or she might have periods that occur 2-3 times in a month and involve spotting or extremely heavy flow. Alternatively, she may have heavy episodes of bleeding every 2-3 months. Irregular periods are simply what is irregular for you.
For the most part, we don’t worry at the clinic about a missed period or two over the course of a year. More variation than that may indicate to us the beginning of perimenopause or a disruption of the natural chain of hormonal events that controls menstruation. A wide variety of factors can be responsible for irregular periods, among them:
- Significant weight gain or loss
- Poor nutrition (or a diet too high in carbohydrates)
- Drug use
- Excessive alcohol use (interfering with how the liver metabolizes estrogen and progesterone)
- Eating disorders
- Increased stress
- Polycystic ovarian syndrome/Estrogen dominance
- Uterine abnormalities (fibroids/cysts/polyps/endometriosis)
- Hormonal imbalances related to perimenopause
- Recent childbirth, miscarriage, or D&C
As you can see, there are many different ways a woman can be irregular for as many different reasons, and it can be very confusing when it happens.
Why does being stressed cause irregular periods?
When we are stressed, regardless of the source (danger, personal relationships, work, environment) our adrenal glands are designed to secrete the hormone cortisol (read more in our articles in our Adrenal Health section). Cortisol has a direct impact on the sex hormones estrogen, progesterone, and DHEA. Eating disorders, dieting, drug use, and reliance on stimulants like caffeine and alcohol are also interpreted by the body as kinds of stress. Poor nutrition seems to physically change the proteins in the brain so they can no longer send the proper signals for normal ovulation.
Am I in menopause if I have irregular periods?
No – irregular periods are generally an indication of hormonal imbalance, not necessarily related to menopause. Strictly speaking, women aren’t considered menopausal until they have gone for one year without a menstrual period.