Are your periods coming at the wrong time, heavier than usual, or missing completely? Menstrual irregularities cover missed periods (amenorrhea), very heavy bleeding (menorrhagia), spotting between cycles, and cycles that change length. These shifts can be annoying and scary. The good news: many causes are common and treatable.
Pregnancy is the first thing to check when a period is late. After that, think about weight changes, intense exercise, and stress — all of these can delay ovulation. Polycystic ovary syndrome (PCOS) causes irregular cycles and often acne or extra hair. Thyroid problems and high prolactin levels also disrupt periods. Hormone changes from starting, stopping, or switching birth control can cause spotting or irregular timing. Some medicines, like certain antidepressants or chemotherapy, may affect your cycle too.
Perimenopause (the years before menopause) brings unpredictable cycles and heavier or lighter bleeding. Uterine causes — fibroids, polyps, or infection — may cause heavy or prolonged bleeding. If you have very heavy bleeding or severe pain, a structural cause should be checked.
Start tracking. Use a simple app or a notebook to log period start and end dates, flow (light/medium/heavy), pain, and spotting. Tracking makes conversations with your doctor faster and more useful. Take a home pregnancy test if your period is late and you’re sexually active.
Small lifestyle moves help: aim for steady weight, cut extreme workouts if your cycle stops, sleep more, and manage stress with short walks or breathing exercises. For pain and lighter bleeding, over-the-counter NSAIDs like ibuprofen can reduce cramps and blood loss. If you feel dizzy or have very heavy flow, rest and seek care.
Your doctor may order a few simple tests: pregnancy test, complete blood count (to check for anemia), TSH (thyroid), and prolactin. An ultrasound can look for fibroids or polyps. For fertility concerns, medicines like clomiphene (Clomid) are sometimes used to induce ovulation — that’s a discussion for a specialist.
Common treatments include hormone therapy (combined birth control or progestin), an IUD that reduces bleeding, tranexamic acid for heavy flow on menstrual days, and iron supplements if you’re anemic. Treatment choice depends on cause, how heavy bleeding is, whether you want to get pregnant, and your health history.
Go to the ER if you’re soaking a pad in an hour, fainting, passing large clots and feeling weak, or have a very high fever with bleeding. Otherwise, book a clinic visit when you notice a clear change for 2–3 cycles, severe pain, or symptoms like shortness of breath or chest pain.
Tracking, a few simple tests, and targeted treatments fix most problems. If you want, bring your cycle log to your appointment — it speeds diagnosis and gets you back on track faster.