Irregular Periods: When to See a Doctor

A normal menstrual cycle ranges from 21-35 days, averaging 28 days. Period duration is normal between 2-7 days. Blood loss is around 30-80 ml (approximately 3-7 normal pads/tampons). Persistent deviations outside these ranges or sudden changes may warrant evaluation.

Types of irregularity:

• Oligomenorrhea: Periods more than 35 days apart — often PCOS, hypothyroidism, or high prolactin
• Polymenorrhea: Periods less than 21 days apart — anovulatory or luteal insufficiency
• Menorrhagia: Bleeding longer than 7 days or more than 80 ml — fibroids, polyps, coagulopathy
• Metrorrhagia: Bleeding between periods — endometrial pathology, hormonal irregularity
• Amenorrhea: No periods at all — pregnancy (most common), early menopause, hypothalamic amenorrhea (stress/sport/diet)

Go to a doctor immediately: Bleeding soaking more than one pad every hour, passing large clots, shortness of breath, dizziness or palpitations due to blood loss, no period for more than 3 months (after pregnancy is ruled out), period with fever above 38°C (100.4°F), recurring bleeding after intercourse, postmenopausal bleeding.

Schedule a doctor visit: Periods became irregular (suddenly), period lasting longer than 7 days, period coming more than 35 days apart (3+ times), severe cramps with pain affecting daily life, intermenstrual bleeding, hair growth/acne/weight gain + period irregularity (could be PCOS).

Important age ranges: Menarche (first period) is normal between ages 9-15. First 1-2 years irregularity is expected (HPO axis maturing). Periods become more regular between 30-40. Perimenopause may begin in the 40s, cycles shorten/lengthen. Menopause normal between 45-55.

Preparation before doctor visit: Bring last 3-6 months of period records (date, duration, flow amount, pain), medications/supplements you use, weight changes, stress intensity, symptoms (acne, hirsutism, hot flashes). This data speeds up your doctor's decision.

Possible tests: Blood test (FSH, LH, estradiol, prolactin, TSH, AMH), pelvic ultrasound (fibroids, cysts, endometrial thickness), if needed hysteroscopy or MRI. Tests are usually requested on cycle days 2-5 (follicular phase).