Menstrual Irregularities

Irregular Periods & Heavy Bleeding: When to Visit a Provider

A woman holds a menstrual cup and looks at a menstrual timing app. Most women have changes in their periods from time to time. A period may come a few days early. It may be a little heavier or lighter than usual. In many cases, small changes are normal.

But some period changes should not be ignored.

If your periods are very heavy, painful, missing, unpredictable, or happening more often than usual, it may be a sign of a menstrual irregularity. These changes can affect your comfort, energy, mood, and daily life.

At The Gabrielson Clinic, we help women understand what is normal, what may need treatment, and what options are available.

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What Are Menstrual Irregularities?

Menstrual irregularities are changes in your normal monthly cycle. These changes may affect how often your period comes, how long it lasts, how heavy it is, or how it feels.

A typical period length is about four to seven days. A normal menstrual cycle often ranges from 21 to 35 days. Periods may be considered irregular if they happen fewer than 21 days apart, more than 35 days apart, last longer than seven days, or are much heavier or lighter than usual.

Common Signs of Irregular Periods

Menstrual irregularities can show up in several ways.

You may have irregular periods if you notice:

Periods that come too close together
Periods that are more than 35 days apart
Missing three or more periods in a row
Bleeding that is much heavier or lighter than normal
Periods that last longer than seven days

Severe cramps, pelvic pain, nausea, or vomiting
Spotting between periods
Bleeding after sex
Bleeding after menopause
Soaking through a pad or tampon in an hour

These changes can be signs that your body needs attention.

Heavy Menstrual Bleeding

Heavy menstrual bleeding is one of the most common reasons women seek care for period problems.

Heavy bleeding may include:

Soaking through a pad or tampon often
Needing to change leak protection during the night
Passing large clots
Bleeding for more than seven days
Feeling tired, weak, or lightheaded during your period
Avoiding work, exercise, or social plans because of bleeding

Heavy bleeding can affect your physical, social, and emotional well-being. It can also lead to fatigue and other symptoms if blood loss becomes significant.

Are Irregular Periods More Than Abnormal Bleeding?

Yes. Menstrual irregularities are not just about heavy bleeding.

They can also include changes in the timing of your period, missed periods, severe pain, mood changes, spotting, or bleeding after sexual intercourse. Some women may have very light periods. Others may stop having periods for several months.

Because menstrual irregularities can happen for many reasons, it is important to look at the full picture.

Types of Menstrual Irregularities

There are different types of menstrual irregularities. Knowing the type can help your provider understand what may be causing the problem.

Amenorrhea: Missing Periods

Amenorrhea means your periods have stopped. Missing a period for 90 days or more may be abnormal unless you are pregnant, breastfeeding, or going through menopause.

Oligomenorrhea: Infrequent Periods

Oligomenorrhea means your periods happen less often than expected. This may mean going more than 35 days between periods or having only six to eight periods in a year.

Dysmenorrhea: Painful Periods

Dysmenorrhea means painful periods or severe menstrual cramps. Mild discomfort can be normal, but severe pain that affects daily life should be checked.

Abnormal Uterine Bleeding

Abnormal uterine bleeding includes bleeding between periods, very heavy bleeding, or bleeding that lasts longer than normal.

What Causes Irregular Periods?

Irregular periods can happen for many reasons. Some causes are mild and temporary. Others may need medical treatment.

Common causes include:

Hormone changes
Stress
Weight changes
Intense exercise
Perimenopause
Pregnancy or breastfeeding
Changes in birth control

Certain medications
Thyroid problems
Polycystic ovary syndrome, or PCOS
Endometriosis
Fibroids or polyps
Pelvic infections
Bleeding disorders

Your provider can help find the cause and recommend the right next step.

Irregular Periods During Perimenopause

A woman clutches her abdomen and reaches for pads. Irregular periods are common during perimenopause.

Perimenopause is the time leading up to menopause. During this stage, hormone levels rise and fall. This can cause periods to become heavier, lighter, closer together, farther apart, or less predictable.

Even though period changes can be common during perimenopause, very heavy bleeding, bleeding after sex, or bleeding after menopause should always be discussed with a provider.

When Should You See a Provider for Irregular Periods?

You should talk with a women’s health provider if your period changes are new, severe, or affecting your life.

Schedule an appointment if you have:

Heavy bleeding that soaks through a pad or tampon every hour
Bleeding that lasts longer than seven days
Bleeding between periods
Bleeding after sex
Bleeding after menopause
Severe period pain or pelvic pain

Periods that suddenly become very irregular
Missing periods for three months or more
Fatigue, dizziness, or shortness of breath
Nausea or vomiting with your period
Concern that you may be pregnant

These symptoms may not always mean something serious, but they are worth checking.

Hysteroscopy for Abnormal Bleeding

A hysteroscopy is an outpatient procedure that allows your provider to look inside the uterus.

During this procedure, a thin lit tool is used to view the uterine lining. Hysteroscopy may be used to help diagnose abnormal bleeding, postmenopausal bleeding, or possible polyps.

This can help your provider better understand what is causing your symptoms and which treatment may be best.

Treatment for Irregular Periods

Treatment depends on what is causing the irregular bleeding, your age, your symptoms, and whether you want to become pregnant in the future.

Treatment options may include:

Lifestyle changes, such as stress management or healthy weight support
Hormonal birth control to help regulate bleeding
Hormone therapy, especially if symptoms are related to perimenopause
Anti-inflammatory medicine to help with cramps or bleeding
Tranexamic acid to help reduce heavy bleeding

Antibiotics if an infection is causing symptoms
An IUD that releases hormones to lighten periods
Procedures to remove fibroids or polyps
Endometrial ablation for heavy bleeding in certain patients

Your provider will help you choose a treatment plan that fits your needs.

Ablation Procedures

An ablation is a quick, one-time outpatient procedure to lighten or end your heavy or abnormal bleeding.

Ablation benefits include:

No pills, incisions, or pre-treatment medicine
May return to work in 48 hours
Mild to no pain
Can be performed anytime, even during your cycle
90% of women return to normal, light, or no periods at all.

We offer the following minimally invasive and effective ablation procedures for heavy bleeding:

Endometrial Ablation for Heavy Periods

Endometrial ablation is a minimally invasive procedure that treats the lining of the uterus. The goal is to reduce or stop heavy bleeding. It is not meant for women who want to become pregnant in the future.

NovaSure Endometrial Ablation

NovaSure Endometrial Ablation is a quick outpatient procedure used to treat heavy menstrual bleeding.

During the procedure, a small device is placed through the cervix and into the uterus. The device uses radiofrequency energy to treat the uterine lining. The treatment itself takes about 90 seconds.

NovaSure may be an option for women who are finished having children and want a treatment that may reduce or stop heavy periods.

Hydrothermal Ablation

Hydrothermal Ablation is another outpatient treatment for heavy bleeding.

This procedure uses heated saline to treat the uterine lining. It may be helpful for some women, depending on the shape of the uterus and the cause of bleeding.

Your provider can explain whether ablation is right for you.

What to Expect After Ablation

Recovery can vary, but many patients return to normal activities within a few days.

After ablation, some women may have cramping, watery or pink discharge, or temporary changes in urination. These symptoms are usually part of the healing process, but your provider will explain what to expect and when to call with concerns.

It is important to know that ablation is not birth control. Pregnancy after ablation can be dangerous, so you still need reliable birth control if pregnancy is possible.