If you believe that a “normal” menstrual cycle is one that comes every 28 days and lasts about 5 days, you would not be alone. The truth is, though, that a normal menstrual cycle may come anywhere between 21-38 days and may last up to 8 days. This usually is reassuring to many patients who fear that something may be wrong with them. Still, many patients experience irregular bleeding at some point, and this can sometimes be cause for concern.
Abnormal or irregular menstrual bleeding usually includes situations like:
- Bleeding between menstrual cycles
- Periods that come more than 38 days between cycles
- Bleeding after intercourse
- Bleeding after menopause
- Periods that last longer than 7-9 days
Abnormal bleeding can sometimes (but not always) be caused by:
- Undiagnosed or abnormal pregnancies, such as miscarriages or ectopic pregnancies
- Birth control or IUDs
- Thyroid or hormonal imbalances, such as PCOS (polycystic ovarian syndrome)
- Uterine fibroids or polyps
- Pre-cancerous lesions or cancer (particularly uterine or cervical cancer, although rare)
Interestingly, abnormal menstrual cycles are more common in certain age groups. We find that in young girls who are first starting to get their period and in women who are peri-menopausal, periods may come more or less frequently.
If you have noticed irregular or abnormal bleeding that you believe is problematic, you should make an appointment with your gynecologist. They can discuss your symptoms and perform some examinations, as well as order the appropriate tests if needed. This might include simple blood tests that can detect hormonal imbalances or early pregnancies. An ultrasound can help identify abnormalities of the uterus or ovaries. Lastly, a biopsy of the uterus can be performed to rule out a pre-cancer or cancer. It’s important to remember that these tests are used in rare instances where abnormal bleeding is caused by a more severe health concern. However, it’s always safe to discuss your concerns with your gynecologist who can make the best recommendation.
Abnormal menstrual bleeding is common and very treatable. Your gynecologist will likely be able to help normalize your bleeding with medication first. Options may include birth control pills, IUD’s, patches, or vaginal rings. If tests find that your bleeding is the result of something more severe, surgery can sometimes be performed. Your gynecologist will make sure you understand your options during an appointment.
Whether it’s problematic or not, it’s important to listen to your body and talk to your gynecologist about bleeding that is abnormal or outside of your regular period cycles. To schedule an appointment with our team of women’s health experts, contact our New York City office by calling or filling out our online form.