Many women experience unusual menstrual cycles at some point in their lives. For some, it can be an issue during the teenage years. For others, it becomes noticeable just before menopause. Virtua OB/GYN Monica Agar, MD, has great information and advice to help you understand irregular cycles and guide you toward solutions.

First, what is normal?

• Skipped or irregularly timed cycles for the first 2 years after menstruation begins
• Absence of a period by age 14 in the presence of other signs of maturity (e.g. breast development and pubic hair
• Discomfort and mood swings (including PMS and premenstrual dysphoric disorder, or PMDD)

What are menstrual irregularities?

• Shorter than 21 days, longer than 35 days
• Beginning before age 9 or after age 16
• Excessively heavy flow
• Breakthrough bleeding (intermittent flow at unexpected times)
• Excessive pain (known as dysmenorrhea)
• Menstrual migraines

What is the most common age for irregular menstruation?

All women of reproductive age can be affected. Dr. Agar encounters more issues with irregularly timed cycles (too frequent or infrequent) and painful periods in younger women, while women in their 40s tend to have more issues related to heavy menstrual flow.

What causes irregularities?

In a sexually active woman, the most common cause of a missed period is pregnancy. Assuming you’re otherwise healthy and not on any hormonal regimens, Dr. Agar explains that intensive exercise regimens, eating disorders or significant weight changes, or thyroid disorders could be to blame for your irregular periods.

Aside from the physical explanations, stress, anxiety and depression can have a serious impact on your cycle as well.

How are irregular cycles controlled?

Dr. Agar suggests discussing hormonal contraceptives with your gynecologist. Birth control is very effective at regulating cycle timing, decreasing menstrual flow and alleviating painful cramps. Many women get relief from PMS/PMDD symptoms as well. Over-the-counter pain relievers also are great for relieving cramps and controlling flow.

When should you seek medical attention?

If your daughter starts menstruating before age 9 or after age 16, consult your doctor. Women who find menstrual symptoms to be debilitating or life disrupting also should seek medical attention.

Dr. Agar points out several less obvious conditions that could be affecting menstrual regularity at various ages, including:

• Endometriosis - A condition where the lining of the uterus begins to grow outside of the uterus
• Polyps - Growths on the uterine wall that extend into the uterus
• Fibroids - Common harmless cell masses that grow from muscle tissue of the uterus

It’s important to have a good relationship with your doctor so that you can be honest and open regarding symptoms and concerns. It’s always better to be cautious and discuss causes and solutions, rather than enduring unnecessary suffering.