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Common Period Problems

Changes in Your Period

The menstrual cycle is a truly elegant feedback system. In theory, and most often in practice, it runs like a well-oiled machine with very little intervention. The body produces hormones in a cycle, each one of which causes changes that automatically “flip the switch” to turn itself off and the next hormone in the cycle on. (Get the details in How Ovulation Happens.) Ovulation, of course, is key to getting pregnant, as an explanation of the mechanics of conception makes clear. But ovulation is only part of the continuous cycle.

Changes or abnormalities in your period might be the easiest aspect of your cycle to notice, as actual menstruation is a hard-to-ignore symptom. Irregular menstrual cycles—having cycles that are shorter than 21 days, longer than 35 days, or vary between extremes—are very common. You can actually be “regularly irregular.” And most women will have times when their periods get a little wacky due to illness, travel, or stress. Still, variations can be worrying. Other symptoms may be more subtle, but are worth noticing. For example, even if a woman has some periods, it doesn’t mean that she is ovulating. The body can still shed the uterine lining without ovulation occurring. Particularly if pregnancy is your goal, you should have your worries evaluated.

Over the years, readers have submitted questions to Babyzone.com, which we asked women’s health specialists to answer. The following questions represent the most common period concerns and curiosities. If you have a persistent problem or anxiety, definitely check with your own gynecologist.

I went off the pill about two months ago, and I have not had a menstrual cycle since then. For a couple of days I had a colored discharge. Could this be a menstrual cycle? Is it still possible to conceive if my regular menstrual cycle has not come back?

Yes, it’s possible to conceive before a real period, assuming you ovulate. Generally, menstrual bleeding happens only after you ovulate. If you fail to ovulate (it’s often delayed after being on the pill), you can have some dysfunctional bleeding, which could look like what you describe. Give it some time. If you’re not cycling normally in another month, check with your doctor: Doctors usually give such disorders a good three months to straighten out.

Common Period Problems

My periods have always been very regular, but the last three months they have changed. I have about three days of very light spotting, then the next 24 to 36 hours it is very heavy, with lots of cramping and clots. I have had some clots before, but not like this; they vary from the size of a dime to a quarter. Then it goes back to light spotting for another one to two days. Are clots normal or should I be concerned?

Your periods will change over the course of your premenopausal life. This may be a normal transition at whatever age you are, but any change should be reported to your doctor to rule out polyps, precancerous changes, fibroids, hormonal problems—things like that. It’s probably nothing, but let your doctor prove that.

I usually have a 26-day cycle with no abnormal bleeding. But now I’ve been experiencing spotting on and off for the last 13 days. What causes this? Can I conceive if I’m having such an abnormal cycle? What exactly is breakthrough bleeding and how do you tell it apart from menses?

Breakthrough bleeding (BTB) occurs when there’s not enough hormonal support for the lining of your uterus, so it disintegrates and sloughs away. This can happen if you’re on a birth control pill that isn’t strong enough or during occasional cycles where there’s a variation in your regular hormone levels. Be sure to report any irregular bleeding to your doctor.

Irregular or Abnormal Cycles

My normal cycle length is from 27 days to 32 days. The past two months they have decreased seven to nine days each month from the last. How do I detect ovulation if my cycles are never the same, and now are only 19 days apart? Also, why are they happening more frequently?

Addressing this problem starts with determining whether you’re ovulating or not. You may not be ovulating at all, but instead experiencing dysfunctional bleeding. A progesterone test in the latter part of your cycle, even a short cycle, can tell whether you ovulated. If you’re not ovulating, then you might need hormonal manipulation each cycle to “jump start” a normal cycle. This is one thing that Clomid (an ovulation inducer) does. If you are ovulating, then perhaps the second half of your cycle is lackluster. This is called “inadequate corpus luteal phase,” and may need to be supplemented with progesterone, which your body normally makes in the second half of the cycle. With an inadequate corpus luteal phase, it is making too little for a healthy cycle (or pregnancy). (Read more in our article Irregular Menstrual Cycles and Fertility.)

I had two periods last month—one at the beginning and at the end. Does the second one count for the next month?

It is a misconception that the “monthly” menses follow the calendar months. Every woman cycles according to her own body’s clock. Women can have cycles that repeat anywhere from every 21 days to every 40 days or so. Also, the menstrual cycle is influenced by many other factors, including stress, exercise, diet, weight, and illness. So even though most women have a period at about the same interval from month to month, every woman is entitled to a fluky one every now and then. For women who have the timing of their periods “all over the map,” once major gynecological concerns have been addressed, the irregular cycles can be manipulated into a normal rhythm using birth control pills.

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