• Getting Pregnant
• Infertility

Gain Control Over Irregular Periods

Irregular periods can make it difficult and frustrating to predict when you will ovulate.

Irregular periods can stem from both minor and more complex conditions, from hormonal imbalances to uterine fibroids. 

But take heart. There are many treatments and procedures today to help regulate rogue menstrual cycles, reduce heavy menstrual bleeding and track ovulation, even with an irregular cycle.

If you're trying to get pregnant, even though it may take a little longer or require some extra effort, many women with irregular menstrual cycles do get pregnant and deliver healthy babies.

The more you learn about how your cycles work, the better equipped you will be.

What Are Irregular Periods? 

If you have irregular periods, you should talk with your doctor to get a diagnosis. Irregular periods are also called metrorrhagia and occur at unpredictable intervals. The typical time between periods is 28 days. Signs of irregular cycles include:

• Menstrual cycles that occur infrequently (more than 35 days apart)
• Menstrual cycles that occur often (fewer than 21 days apart)

The most common causes of irregular periods are:

• Stress
• Low thyroid levels
• Hormone fluctuations related to:
  • Starting, stopping or missing birth control pills, patches or doses of estrogen supplements

Heavy Menstrual Bleeding 

Some women experience heavy or prolonged menstrual bleeding, called menorrhagia. This is another type of irregular period. You have heavy menstrual bleeding if you:

• Need to change your pad or tampon every 1 to 2 hours because it is soaked
• Bleed longer than 7 days

If you have these symptoms, talk with your doctor. Spotting or bleeding between periods is also a sign of a problem, and your doctor can help you understand what is causing your uterine bleeding.

Heavy menstrual bleeding can be caused by:

• Hormonal imbalance
• Ovulation problems
• Uterine fibroids or polyps
• Endometriosis
• Intrauterine devices (IUD)
• Problems with birth control methods
• Bleeding disorders

Your doctor can do tests to find the cause of your heavy bleeding. The most common include:

• Pelvic exam. Your doctor will examine your pelvic organs, much like during an annual gynecological exam, to check for any changes or problems.
• Pap test. The doctor takes a sample of cells from your cervix to check for any problems.
• Ultrasound. This test uses sound waves to create images of your uterus. It can show endometriosis or other growths on the outside and inside of the uterus, including uterine fibroids and polyps. 
• Hysteroscope. This test is used if further testing and treatment are needed after an ultrasound. A tiny camera inserted through the vagina to see the cervix and inside the uterus.

Treatment Options

Once your doctor knows the cause of your irregular periods, together you can identify the best approach for you, especially if you want to get pregnant. 

Treatments may be medical and/or surgical. Medical therapies for irregular periods include trying to regulate your menstrual cycle using:

• Hormones, including birth control pills
• IUD

Even if you’re trying to get pregnant, using birth control for a few months can secure getting your cycle back on track. Then, when you go off the pill to attempt pregnancy, you may find it easier to predict when you ovulate, which can help achieve pregnancy faster.

Treatments for heavy bleeding depend on your specific condition, though. These include medical and surgical interventions. 

Some procedures — like surgery for endometriosis — can improve your fertility.

Pregnancy is not recommended after some surgical treatments, including endometrial ablation, so be sure to discuss with your doctor the best procedure for you.

• Hormone therapy is used to shrink uterine fibroids and stop or regulate the menstrual cycle.
• Other surgical options include:
  • Endometrial ablation destroys the uterine lining and stops the bleeding.
  • Embolization stops the blood flow to the uterus and to fibroids.
  • Myomectomy removes uterine fibroids but not the uterus.
  • Hysterectomy removes the entire uterus. This procedure often is used when all other treatments fail.

How to Track Ovulation with Irregular Periods

Even if you have irregular periods, you still can track your body’s changes to help you predict when you will ovulate. This lets you know the best time to have intercourse to try to get pregnant.

Talk with your doctor about one or more methods that may work best for you. Options include:

• Chart your cycle. Use a calendar to record when your period begins and ends and when you think you ovulate for a few months. This may help you to notice certain patterns. The information will also be helpful for your doctor.
• Monitor changes in cervical mucus. When your body gets ready to ovulate, the mucus increases, thickens and resembles egg whites. 
• Basal body temperature. Your body temperature changes when you get ready to ovulate. If you’re keeping track of your basal body temperature, you will see an increase in that temperature when you ovulate.
• Use an ovulation predictor kit. They work by detecting an increase in luteinizing hormone in your urine. The levels of LH jump 24 to 48 hours before ovulation. If you have a longer length of time between periods, you may have to perform the predictor tests more frequently each month.

Don’t get discouraged if it takes a few months to be able to predict when you ovulate. The longer you track your body’s changes and the more you learn about how your cycles work, the better equipped you will be.

Source: American Pregnancy Association; WhatToExpect.com; American Congress of Obstetricians and Gynecologists