What Counts as Irregular Bleeding?
A normal menstrual cycle is typically 24–35 days, with variation of no more than a few days between cycles. Signs of irregular bleeding include:
- Too few or too many periods per year
- Spotting or brown discharge before a period
- Very heavy flow (soaking multiple pads per hour) or very light flow
- Mid-cycle bleeding or bleeding after intercourse
Potential causes of irregular bleeding include:
Hormonal Issues
- Estrogen too high or low
- Progesterone imbalance
- Thyroid dysfunction
- High prolactin
- Adrenal dysfunction
Structural Concerns
- Ovarian cysts
- Fibroids
- Uterine or cervical polyps
- Cervical ectropion
Blood-Related Factors
- Genetic or acquired clotting disorders (e.g., Factor V Leiden)
How Irregular Bleeding Is Evaluated
A thorough workup helps uncover the root cause:
- Hormone Testing: Estrogen, progesterone, LH, FSH, thyroid hormones, prolactin, testosterone
- Cycle Mapping: Tracking hormone patterns using urine tests and blood work at multiple points
- Imaging: Ultrasound to assess ovaries, uterine lining, fibroids, cysts, or polyps
- Pelvic Exam & Swabs: Checks for infection and structural changes
- Endometrial Biopsy: Evaluates uterine lining health
Treatment and Management
Lifestyle & Nutrition
- Diet and supplements tailored to support hormone balance depending on which hormones are high or low
Medical Interventions
- Bioidentical hormones to correct estrogen or progesterone imbalances
- Medication or surgery for ovarian cysts, fibroids, or polyps
- Cervical treatments (e.g., silver nitrate) for ectropion
- Antibiotics or probiotics for infections
Monitoring & Tracking
- Chart cycles and track hormone shifts to ensure treatment is effective
- Long-term tracking empowers consistent cycle management and overall health
Key Takeaways
- Irregular periods are not normal and often indicate hormonal, structural, or blood-related issues.
- Comprehensive evaluation—including hormone testing, imaging, and pelvic exams—is essential.
- Treatment can include lifestyle adjustments, supplements, medical interventions, and ongoing monitoring.
- Restoring balance and regular cycles may take 3–6 months, but consistent management improves long-term health and well-being.
Next Steps
If you struggle with irregular cycles, Dr. Sarah and the Vera Health and Fertility team can provide a personalized, holistic plan to evaluate causes, balance hormones, and restore cycle consistency.