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Irregular Periods: Causes, Symptoms, Fertility, and How to Manage

Zoe Kaplan
Zoe Kaplan

One in three women experience some type of irregular periods. If you're experiencing them, here are potential causes and management strategies

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Mar 15, 2024
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One in three women experience some type of irregular periods. If you're experiencing them, here are potential causes and management strategies

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One in three women experience some type of irregular periods. If you're experiencing them, here are potential causes and management strategies

Irregular periods, medically known as oligomenorrhea or menstrual irregularities, can be frustrating, confusing, and even concerning. While menstrual cycles typically happen every 21 to 35 days, with bleeding lasting two to seven days, irregular periods deviate from this norm. You might have a less frequent period, periods at seemingly random intervals, longer periods, or something completely different. 

Irregular periods don’t always have to be cause for concern, but if you’re experiencing them, it’s crucial to understand potential causes, management strategies, and when to see a doctor. Here’s your go-to guide to irregular periods. 

What are irregular periods?

Irregular periods refer to variations in the menstrual cycle length, duration, or amount of bleeding. They can manifest in several ways, including:

  • Infrequent periods (oligomenorrhea): menstrual cycles more than 35 days apart.
  • Frequent periods (polymenorrhea): menstrual cycles occurring less than 21 days apart.
  • Absent periods (amenorrhea): complete absence of menstruation for three or more consecutive cycles. 
  • Heavy or prolonged bleeding (menorrhagia): excessive or extended menstrual bleeding beyond the usual seven days. This type of irregular period is more common among people over 35 and about one in five people with periods experience them. 

How common are irregular periods?

Irregular periods are much more common than you might think — according to a variety of studies, the prevalence can range from 5 to 35.6%, depending on age, country of residence, and occupation. That means as many as one in three people with experience experience some sort of irregularity in their periods during their reproductive years.

Some types of irregular periods are more common than others. For example, a little more than one in ten people with periods — 13.5% — experience infrequent periods, while heavy bleeding is a more common. About one in five people with periods experience heavy bleeding, and it’s more common among people over 35.

What causes irregular periods?

Irregular periods aren’t always a cause for concern, but it’s crucial to understand why you experience them. These irregularities can stem from various factors, including lifestyle choices, underlying health conditions, and other causes.

Irregular periods caused by lifestyle factors

Sometimes, irregular periods stem from lifestyle factors, including:

  • Stress: High levels of stress can disrupt hormone levels, leading to irregularities in the menstrual cycle. 
  • Weight fluctuations: Significant weight loss or gain can affect hormone production and disrupt the menstrual cycle.
  • Exercise: Intense or excessive physical activity can alter hormone levels, causing irregular periods.
  • Poor nutrition: Inadequate intake of essential nutrients can impact hormone balance and menstrual regularity.

Irregular periods caused by underlying health conditions

Irregular periods can be a sign of a health condition underneath the surface. If you’re experiencing irregular periods, it can be a sign of:

  • Polycystic ovary syndrome (PCOS): A common hormonal disorder characterized by cysts on the ovaries, insulin resistance, and irregular periods.
  • Thyroid disorders: Conditions such as hypothyroidism or hyperthyroidism can disrupt hormone production and menstrual cycles.
  • Endometriosis: A condition where the tissue lining the uterus grows outside of it, leading to irregular bleeding and pelvic pain.
  • Reproductive disorders: Conditions such as uterine fibroids or ovarian cysts can cause irregular periods.

Remember, just because you have irregular periods doesn’t mean you definitely have a health condition. Becoming aware is the first step in taking control of your health; we’ll go over when it might be time to consult with a healthcare professional.

Irregular periods caused by other causes

If it’s not lifestyle changes or an underlying health condition, irregular periods may be caused by one of two factors:

  • Medications: Certain medications, such as hormonal contraceptives or anticoagulants (medicines that prevent blood clots), may affect menstrual regularity.
  • Perimenopause: The transitional phase before menopause can cause irregular periods due to fluctuating hormone levels. Learn the first signs of perimenopause.

Do irregular periods affect my fertility?

While irregular periods don’t always directly affect your fertility, they can make conception more difficult.

Impact on ovulation

Irregular periods can signal irregular ovulation, including a period without ovulation (also known as anovulatory cycles). Ovulation is the process when a mature egg is released from the ovary for fertilization; without ovulation, sperm has nothing to fertilize, and therefore there’s no chance of pregnancy. 

Underlying health conditions

Sometimes, underlying health conditions are the root cause of irregular periods. Conditions such as PCOS, thyroid disorders, and reproductive tract abnormalities, which can cause irregular periods, may also impact fertility. PCOS, for example, is a common hormonal disorder associated with irregular periods and anovulatory cycles, leading to difficulties in conceiving.

>>RELATED: PCOS and Pregnancy: What to Know If You're TTC with PCOS

Timing of intercourse

Irregular periods can make it more challenging to time intercourse optimally for conception. Tracking ovulation through methods such as basal body temperature charting, recognizing signs of ovulation, or using ovulation predictor kits that measure your hormones can help.  

It's essential to remember that not all individuals with irregular periods will experience fertility problems. Many people with irregular cycles can still conceive naturally, especially with appropriate management and support from healthcare providers. 

Irregular periods: When to see a doctor

While occasional irregularities in the menstrual cycle are common and often benign, certain signs warrant medical evaluation. It's essential to consult a healthcare professional if you experience:

  • Persistent irregular periods for several months
  • Severe or prolonged menstrual bleeding
  • Symptoms such as pelvic pain, abnormal discharge, or fever
  • Concerns regarding fertility or reproductive health

How to manage irregular periods

Managing irregular periods often depends on your end goal. For example, some people want to manage irregular periods to have more predictable periods, out of convenience; others are focused on conception, and want to regulate their cycle for more predictability; some people are focused on the underlying causes of irregular periods and focus on treating health conditions.

Managing irregular periods involves various strategies aimed at regulating the menstrual cycle and addressing underlying causes.

Lifestyle interventions 

Just as lifestyle factors can contribute to irregular periods, interventions can help regulate your cycle, typically by helping regulate your hormones. Lifestyle interventions to help manage irregular periods include:

  • Stress management: Incorporating stress-reducing techniques like mindfulness, yoga, or deep breathing exercises can help regulate hormone levels, and, therefore, your cycle. 
  • Balanced diet: Maintaining a healthy diet rich in fruits, vegetables, whole grains, and lean proteins can support hormonal balance and overall well-being.
  • Moderate exercise: Engaging in regular but moderate physical activity can promote healthy hormone levels and regulate menstrual cycles. Learn how to sync your workouts to different phases of your cycle. 

Addressing underlying health conditions

​​If irregular periods persist or are accompanied by concerning symptoms, it's crucial to seek medical advice. A healthcare provider can conduct a thorough evaluation to identify any underlying health conditions contributing to menstrual irregularities. They might recommend 

various diagnostic tests to assess hormone levels, thyroid function, and reproductive health. These tests may include blood tests, pelvic exams, ultrasound imaging, or specialized procedures to evaluate the uterus and ovaries.

Once a diagnosis is established, treatment strategies can be tailored to address specific underlying health conditions contributing to irregular periods. Treatment options may include:

  • Hormonal therapy: Hormonal medications, such as oral contraceptives, hormone replacement therapy, or medications to regulate insulin levels in conditions like PCOS, can help restore hormonal balance and regulate menstrual cycles.
  • Surgical intervention: In cases of severe endometriosis, uterine fibroids, or ovarian cysts, surgical procedures may be necessary to remove abnormal tissue or cysts and restore normal menstrual function.
  • Thyroid management: Treatment for thyroid disorders, such as thyroid hormone replacement therapy or medications to regulate thyroid function, can help stabilize hormone levels and improve menstrual regularity.

After initiating treatment for underlying health conditions, regular follow-up appointments with your healthcare provider are essential to monitor progress, adjust treatment as needed, and address any new concerns or symptoms. Remember, addressing underlying health issues not only helps regulate menstrual cycles but also promotes long-term reproductive health and wellness.

Other interventions

Hormonal contraception and other medications can cause irregular periods; if this is the case, you can manage irregular periods by changing contraception methods or addressing underlying conditions:

  • Hormonal contraception: Birth control pills, patches, or hormonal intrauterine devices (IUDs) can help regulate menstrual cycles and alleviate symptoms of irregular periods.
  • Medications: If medications other than hormonal contraceptives are affecting your menstrual regularity, your doctor may prescribe medications such as hormonal supplements or nonsteroidal anti-inflammatory drugs (NSAIDs) to manage underlying conditions contributing to irregular periods.

Tracking irregular periods for conception

If you’re trying to conceive, tracking irregular periods can be an effective way to manage this symptom while you’re trying to regulate your cycle. 

While irregular cycles may present challenges in predicting menstruation and ovulation, several methods and tools can aid in tracking and managing irregular periods:

  • Menstrual calendar: Keep a menstrual calendar or diary to record the start and end dates of each period, along with any accompanying symptoms or changes in menstrual flow. Over time, this can help identify patterns or irregularities in cycle length, duration, and intensity of bleeding.
  • Ovulation tracking: Monitoring ovulation can be particularly useful for individuals with irregular periods who are trying to conceive. Methods such as basal body temperature charting, tracking cervical mucus changes, or using ovulation predictor kits can help identify the fertile window and optimize timing for conception. However, these may be less accurate for irregular periods and without consistent tracking.
  • Ovulation calculators: Online ovulation calculators or fertility calculators can estimate ovulation and fertile days based on inputted menstrual cycle data. While these calculators may be less accurate for individuals with irregular periods, they can still provide valuable insights into potential ovulation timing.
  • Physical symptoms: Paying attention to physical symptoms associated with the menstrual cycle, such as breast tenderness, bloating, or changes in mood, can help you anticipate the onset of menstruation or ovulation, even in the absence of regular cycles.

>>MORE: Top 5 Signs of Ovulation: What To Look Out for if You’re Trying To Conceive

Irregular periods: the bottom line

Irregular periods can be disruptive and distressing, yet you can manage them with lifestyle adjustments, hormonal interventions, or medical treatment. It's crucial to seek medical advice if irregularities persist or are accompanied by concerning symptoms, ensuring timely diagnosis and treatment of any underlying conditions. 

The first step to taking care of your menstrual health is getting informed — and by reading this article, you’re on the right track to promote your overall health and well-being.

About the author

Zoe Kaplan
Zoe Kaplan is a writer and content strategist passionate about creating content that helps people navigate the world a little more easily. Zoe has worked across verticals, from women's career development to reproductive health. You can check out more of her work at zoeakaplan.com.

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Can I take progesterone if I'm breastfeeding?
Yes, progesterone is generally safe while breastfeeding and doesn't significantly affect milk supply. However, always discuss with your healthcare provider before starting any hormone supplementation while nursing.
https://www.oova.life/blog/progesterone-supplementation-guide
Is it safe to take progesterone throughout pregnancy?
Yes, when prescribed by your healthcare provider. Progesterone supplementation in early pregnancy is safe and can reduce miscarriage risk in women with low progesterone or a history of pregnancy loss. Most providers continue supplementation through the first trimester (weeks 10-12) when the placenta takes over.
https://www.oova.life/blog/progesterone-supplementation-guide
Can progesterone supplementation cause weight gain?
Progesterone can cause temporary water retention and bloating, which may show up as a few pounds on the scale, but it doesn't cause true fat weight gain. Most women don't experience significant weight changes from progesterone supplementation.
https://www.oova.life/blog/progesterone-supplementation-guide
Can I switch from pills to suppositories or vice versa?
Yes, but only under your doctor's guidance. The dosing and timing may need adjustment when switching between forms since they're absorbed differently. Never switch on your own, especially if you're pregnant or undergoing fertility treatment.
https://www.oova.life/blog/progesterone-supplementation-guide
Will progesterone supplementation delay my period?
Yes, progesterone keeps the uterine lining intact, so if you're not pregnant and continue taking progesterone, your period will be delayed. Once you stop taking it, your period should start within 2-10 days. If you are pregnant, progesterone helps maintain the pregnancy and you won't get a period.
https://www.oova.life/blog/progesterone-supplementation-guide
Should I take progesterone pills orally or vaginally?
For fertility and pregnancy support, vaginal progesterone is usually preferred because it delivers higher concentrations directly to the uterus. For perimenopause or general hormone balance, oral progesterone often works well and is more convenient. Your doctor will recommend the best route based on your specific needs.
https://www.oova.life/blog/progesterone-supplementation-guide
When should I start taking progesterone after ovulation?
Typically, progesterone supplementation for luteal phase support starts 2-3 days after ovulation (confirmed by LH surge or temperature rise). Your doctor will give you specific timing based on your protocol. Some women start immediately after a positive ovulation test.
https://www.oova.life/blog/progesterone-supplementation-guide
What's better: progesterone cream or pills?
Pills (oral micronized progesterone) are generally more effective and reliable than creams because absorption from creams is inconsistent. For medical conditions like fertility issues, low progesterone, or HRT, prescription pills or suppositories are strongly recommended over over-the-counter creams.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
How can I tell if I have low or high progesterone?
The only definitive way to know is through hormone testing via blood tests or at-home urine tests that measure progesterone metabolites. However, symptom patterns can provide clues: anxiety and irregular periods suggest low progesterone, while bloating and extreme fatigue suggest high progesterone.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
When during my cycle should I test progesterone levels?
Test progesterone levels during the luteal phase, typically 7 days after ovulation or around day 21 of a 28-day cycle. This is when progesterone should be at its peak, making it easier to identify if levels are too low or too high.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
What are the main differences between low and high progesterone symptoms?
Low progesterone typically causes irregular or heavy periods, anxiety, hot flashes, and sleep issues. High progesterone causes bloating, fatigue, intense breast tenderness, and depression-like mood changes. Low progesterone symptoms persist throughout your cycle, while high progesterone symptoms are most intense during the luteal phase.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
Can you have symptoms of both low and high progesterone?
Some symptoms like breast tenderness and mood changes can occur with both low and high progesterone, making it confusing. However, the timing, intensity, and accompanying symptoms differ. Hormone testing is the best way to determine which imbalance you're experiencing.
https://www.oova.life/blog/10-dpo
Can stress affect 10 DPO symptoms?
Yes, stress can worsen or mimic 10 DPO symptoms. Stress increases cortisol, which can cause cramping, fatigue, and mood changes similar to both PMS and early pregnancy. During the two-week wait, try stress-reduction techniques like gentle exercise, meditation, or spending time with loved ones.
https://www.oova.life/blog/10-dpo
Is it better to test at 10 DPO or wait?
It's better to wait until 12–14 DPO for more accurate results. Testing at 10 DPO often leads to false negatives because hCG levels may still be too low. If you absolutely can't wait, use a sensitive early detection test with first morning urine, and be prepared to retest in 2–3 days if negative.
https://www.oova.life/blog/10-dpo
What does implantation bleeding look like at 10 DPO?
Implantation bleeding at 10 DPO is typically light pink or brown, much lighter than a period, and lasts 1–2 days. It's often just spotting when you wipe or a few drops on a panty liner. However, only 15–20% of pregnant women experience implantation bleeding—most don't have any bleeding at all.
https://www.oova.life/blog/10-dpo
Why am I cramping at 10 DPO?
Cramping at 10 DPO can be caused by elevated progesterone (whether you're pregnant or not), implantation (if you're pregnant), or premenstrual cramping. Unfortunately, cramping alone can't tell you if you're pregnant since progesterone causes similar symptoms in both scenarios.
https://www.oova.life/blog/10-dpo
What are the chances of a BFP at 10 DPO?
If you're pregnant, you have about a 50–60% chance of getting a positive test at 10 DPO. This means there's a 40–50% chance of a false negative even if you conceived. Chances improve significantly by 12–14 DPO.
https://www.oova.life/blog/10-dpo
What DPO is most accurate for pregnancy testing?
14 DPO (the day of your missed period) is the most accurate time to test, with 99% accuracy. 12 DPO offers 80–90% accuracy. 10 DPO has only 50–60% accuracy. For best results, wait as long as you can—ideally until 12–14 DPO.
https://www.oova.life/blog/10-dpo
Is 10 DPO too early to test?
10 DPO is considered early for pregnancy testing. While some women get positives at 10 DPO, accuracy is only 50–60% if you're pregnant. For best results, wait until 12 DPO (80–90% accuracy) or 14 DPO/missed period (99% accuracy).
https://www.oova.life/blog/10-dpo
Can you have implantation at 10 DPO?
Yes, implantation can still occur at 10 DPO, though 84% of women have already implanted by this point. Late implantation at 10–12 DPO is normal. If implantation happens at 10 DPO, you won't get a positive pregnancy test for another 2–3 days.
https://www.oova.life/blog/10-dpo
What does a negative test at 10 DPO mean?
A negative test at 10 DPO does not mean you're not pregnant. It's very common to get negatives at 10 DPO even if you conceived. Your hCG levels may still be too low, or implantation may have occurred later. Wait until 12–14 DPO to retest for more accurate results.
https://www.oova.life/blog/10-dpo
Can you get a positive pregnancy test at 10 DPO?
Yes, but only about 50–60% of pregnant women will get a positive at 10 DPO. The other 40–50% have hCG levels that are still too low to detect. If you test negative at 10 DPO, wait 2–3 days and test again.
https://www.oova.life/blog/high-progesterone-symptoms
Can high progesterone cause weight gain?
Yes, elevated progesterone can cause temporary weight gain through water retention and bloating. This is a normal part of the luteal phase and early pregnancy.
https://www.oova.life/blog/how-to-increase-estrogen
Does stress affect estrogen levels?
Yes, chronic stress elevates cortisol, which can suppress estrogen production and disrupt hormonal balance. Stress reduction through meditation, yoga, adequate sleep, and self-care practices helps maintain optimal estrogen levels.
https://www.oova.life/blog/how-to-increase-estrogen
When should I consider medical treatment for low estrogen?
Consider medical intervention if natural methods don't improve symptoms after 3 months, if symptoms severely impact quality of life, if you're experiencing early menopause (before 40), or if you have fertility concerns. Hormone replacement therapy may be appropriate in these cases.
https://www.oova.life/blog/how-to-increase-estrogen
What are the signs that my estrogen is increasing?
Signs of rising estrogen include more regular menstrual cycles, reduced hot flashes, improved vaginal lubrication, better mood stability, increased energy, and improved skin elasticity. You may also notice reduced symptoms that originally indicated low estrogen.
https://www.oova.life/blog/how-to-increase-estrogen
Can exercise increase estrogen levels?
Yes, moderate exercise stimulates estrogen release and helps maintain hormonal balance. Aim for 150 minutes of moderate cardio weekly plus strength training twice per week. However, excessive exercise can actually lower estrogen, so balance is key.
https://www.oova.life/blog/how-to-increase-estrogen
How long does it take to increase estrogen naturally?
With consistent dietary and lifestyle changes, you may notice improvements in symptoms within 4-8 weeks. However, significant hormonal changes typically take 2-3 months. Tracking your cycle and symptoms can help you monitor progress.
https://www.oova.life/blog/how-to-increase-estrogen
What foods increase estrogen levels naturally?
Foods high in phytoestrogens can help increase estrogen naturally. The best options include flax seeds (high in lignans), soy products (tofu, tempeh, edamame), lentils, chickpeas, whole grains (oats, quinoa, brown rice), and garlic. These plant compounds mimic estrogen's effects in the body.
https://www.oova.life/blog/perimenopause
What helps relieve hot flashes quickly?
Cool environments, layered clothing, herbal teas, and medical treatments like gabapentin or HRT may help—depending on severity. Lifestyle changes like reducing caffeine and alcohol can also provide relief.
https://www.oova.life/blog/perimenopause
Are there tests to confirm perimenopause?
Yes. Tests measuring estradiol, LH, and FSH levels can indicate hormonal shifts—but diagnosis is often symptom-based since hormone levels fluctuate widely during perimenopause.
https://www.oova.life/blog/perimenopause
How do I know it's perimenopause and not something else?
A doctor may recommend hormone testing (like LH, E3G, and PdG) and track symptom timing. Diagnosis is often based on symptoms combined with age and menstrual pattern changes.
https://www.oova.life/blog/perimenopause
What's the earliest age perimenopause can start?
Some women begin experiencing symptoms as early as their mid-30s, though perimenopause typically starts between ages 38-45.
https://www.oova.life/blog/perimenopause
Does perimenopause affect mental clarity?
Yes. Brain fog and difficulty concentrating are common during hormone fluctuations in perimenopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
What happens after the last sign of perimenopause?
After your final period, you enter postmenopause. You'll need 12 consecutive months without a period to confirm menopause. Many symptoms gradually improve, though some like vaginal dryness may persist without treatment.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
When do perimenopause symptoms finally stop?
Some symptoms like brain fog improve after menopause, while others like hot flashes may continue for up to 10 years post-menopause. Vaginal symptoms often persist or worsen without treatment. Each person's timeline is different.
https://www.oova.life/blog/high-progesterone-symptoms
Is high progesterone a sign of pregnancy?
Yes, high progesterone is one of the earliest indicators of pregnancy. Progesterone levels rise significantly after conception to support the developing embryo and reach their peak during the third trimester.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
Can you still get pregnant in late perimenopause?
Yes, you can still get pregnant during perimenopause as long as you're having periods, even if they're infrequent. Continue using birth control until you've gone 12 consecutive months without a period and have officially reached menopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
Do symptoms get worse before perimenopause ends?
Yes, most perimenopause symptoms intensify in the final 1-2 years before menopause. Hot flashes peak around your final period, vaginal symptoms worsen, and mood changes increase. However, brain fog typically improves in late perimenopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
How long does late perimenopause last?
Late perimenopause typically lasts 1-3 years before your final period. However, the exact duration varies significantly from person to person. You've reached menopause after 12 consecutive months without a period.
https://www.oova.life/blog/high-progesterone-symptoms
What are the symptoms of high progesterone?
High progesterone symptoms include fatigue, bloating, breast tenderness, weight gain, anxiety, depression, headaches, and food cravings. During pregnancy, you may also experience increased nipple sensitivity and muscle aches.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
What are the first signs that perimenopause is ending?
The earliest signs include longer gaps between periods (60+ days), intensifying hot flashes that peak around your final period, and worsening vaginal dryness. These symptoms typically increase in late perimenopause before you reach official menopause.
https://www.oova.life/blog/high-progesterone-symptoms
When should I be concerned about high progesterone?
Consult a healthcare provider if you experience high progesterone symptoms outside your luteal phase when not pregnant, or if symptoms include severe pelvic pain, abnormal vaginal bleeding, or rapid weight gain while on hormone therapy.
https://www.oova.life/blog/high-progesterone-symptoms
How do you test progesterone levels?
Progesterone can be measured through blood tests at your doctor's office or at-home urine tests that measure PdG (a progesterone metabolite). Testing is typically done during the luteal phase, about 7 days after ovulation.

About the Oova Blog:
‍Our content is developed with a commitment to high editorial standards and reliability. We prioritize referencing reputable sources and sharing where our insights come from. The Oova Blog is intended for informational purposes only and is never a substitute for professional medical advice. Always consult a healthcare provider before making any health decisions.

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