Irregular periods means changes in the timing, flow or pattern of menstrual bleeding compared with an individual’s usual cycles. Variations are common during adolescence, around pregnancy changes and in the approach to menopause, but new or marked changes are worth medical evaluation. Below are common causes, warning signs that need prompt attention and which specialists typically assess menstrual irregularities.
A typical cycle for many people falls between about 21 and 35 days, but there is natural variation. Irregularities include missing periods (amenorrhea), infrequent or unusually long cycles, very short or very frequent cycles, heavy or prolonged bleeding, and spotting between periods. Sudden or large changes from your usual pattern are most important to review.
Many factors can change menstrual cycles. Hormonal conditions such as polycystic ovary syndrome (PCOS) and thyroid disorders, significant weight loss or gain, very intense exercise, high stress, certain forms of contraception and pregnancy are common causes. Structural issues in the uterus (fibroids, polyps), pelvic infections and some systemic medical conditions can also affect bleeding patterns.
Seek emergency help if bleeding is so heavy that it causes fainting, severe dizziness, breathlessness or chest pain, or if bleeding cannot be controlled. A sudden, severe abdominal or pelvic pain, or fever with pelvic symptoms, also warrants prompt evaluation. In those situations go to emergency services or contact urgent care.
Initial assessment is usually done by a primary care clinician or a gynaecologist. Evaluation may include a pregnancy test, blood tests (including hormonal and thyroid tests), and pelvic imaging such as ultrasound. Endocrinology may be involved if a broader hormonal disorder is suspected. Adolescent or menopause clinics can provide age-specific assessment when relevant.
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