Last updated: June 30, 2021
Richard Honaker M.D.
Primary Care Physician
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Period problems are a common issue for women. Menstrual cycle changes can cause discomfort and general confusion for those experiencing late or abnormal cycles. If your period is late, and you want to figure out what is going on, you have come to the right place.
What is a Menstrual Cycle?
The menstrual cycle refers to the preparations a women’s body goes through every 28 to 35 days in order to prepare her body for pregnancy. If conception does not occur the lining will shed through the vagina along with the unfertilized egg. This shedding is referred to as a monthly period.
Normal menstrual cycles, periods, occur between 21 days and 35 days, and they can last for two to seven days. Cycles often vary from woman to woman.
Some women experience very heavy and long cycles, while others may have short cycles with light bleeding. Some women’s cycles are quite painful and may require homeopathic treatments such as hot water bottles or over-the-counter pain medication and other women may not even notice any symptoms.
No matter what your symptoms are, it is important to know what is normal for you. A great way to do this is through some of the many free apps that track your menstrual cycle for you. Not only do these help you stay prepared for the onset of your period, but they also allow you to notice any abnormalities and to report these accurately to your doctor.
When tracking your period be sure to note:
- The day your cycle began.
- The amount of flow
- Whether or not you experience any pain
- How long your menstrual cycle lasted?
What is an Abnormal Menstrual cycle?
Changes to your cycle can happen and many can be easily explained. It is important to track what is normal for you so you can report any changes or concerns with your doctor. Some menstrual issues to be on the lookout for include:
- The absence of three or more periods in a row
- Periods lasting longer than seven days
- A flow that is lighter or heavier than normal for you
- Painful cramping and feeling sick
- Spotting after sex, or between menstrual periods
Potential Causes of Abnormal Menstruation
Period problems exist, however, pinning down the causes of abnormal menstrual cycles can be challenging and lab work is important to determine what is going on with your abnormal menstrual cycle.
A few causes of abnormal periods include:
- Uterine Fibroids
- Uterine/Endometrial Polyps
- Polycystic Ovarian Syndrome
- Pelvic Inflammatory Disease
- Uterine Cancer
- Cervical Cancer
A missed period is often the first indication that conception has taken place. Home pregnancy tests have become so sensitive in detecting the pregnancy hormones in urine (human chorionic gonadotropin called or hCG) that many can test days before your expected period.
Exclusive breastfeeding after the birth of your baby can delay the return of your period for weeks, months or even a year. This is because the hormones in your body that help produce breast milk often also signal your body not to produce a monthly cycle. While this can be an unexpected bonus of breastfeeding, it is not recommended to be relied on as a form of birth control. Ovulation can occur anytime in the period after your baby is born and without a backup method of birth control you could find yourself pregnant without knowing it.
We all have stress in our lives, but if your stress is causing changes in your body and delaying your period-it is probably time to look into stress management. Stress hormones are able to affect your body in many ways, even affecting the part of your brain-the hypothalamus-that regulates your period. To get your body back on track you can consider some stress-relieving activities like meditation and exercise. If you continue to experience these symptoms regularly, you can connect with one of our doctors.
This condition occurs when the lining of the uterus (called the endometrium) grows outside of the uterus causing pain and problems for the sufferer. This condition usually involves the ovaries, fallopian tubes and the tissue lining the pelvis. In some rare cases, it may grow beyond the pelvic area. With this condition, the endometrium will continue to thicken and shed, but it has no exit point from the body. Instead, it may develop into painful cysts on the ovaries and irritation to surrounding tissue can lead to the development of scar tissue or adhesions.
Also called leiomyomas or myomas, are non-cancerous muscle growths within the lining of the uterus. Many cases are only detected through routine exams. In a study published by The American Journal of Obstetrics and Gynecology, it was found that fibroids affect up to 70 percent of white women and between 80 and 90 percent of African American women by age 50. While they can cause no symptoms, they can also be responsible for the disruption of your menstrual cycle. Often the symptoms of these growths include prolonged and heavy periods, pain and pressure in the pelvic region and abnormal bleeding.
These growths occur on the inner lining of the uterus. While usually not cancerous, some growths may become cancerous if left untreated. While these polyps can affect women of all ages, it is more common to occur after menopause when the uterine lining is no longer shedding. Symptoms of these polyps can be non-existent or include heavy periods, bleeding after menopause, sex or exercise and bleeding between periods.
Birth control methods
Some birth control methods may stop your normal menstrual cycle. It is important to discuss any side effects of new birth control methods with your doctor to make sure your method is right for you. If you are worried about your chosen birth control, you can chat with a doctor for free.
Polycystic Ovary Syndrome (PCOS)
The leading cause of infertility in women, PCOS can cause irregular and absent periods as well as ovarian cysts. The syndrome is caused by an imbalance of hormones. Women with PCOS have a higher level of male testosterone. This makes it difficult for women to conceive as they often ovulate irregularly or not at all.
Related: PCOS: 10 Common Symptoms
Pelvic inflammatory disease
It is an infection of the female reproductive organs. It often occurs when bacteria enters the vagina during sex and goes on the infect and inflame the surrounding organs. Many women do not have symptoms and are therefore unable to receive the necessary treatment. Other cases provide some telltale symptoms such as heavy vagina discharge with an odour, abnormal bleeding between periods or after sex and pain in your lower abdomen and pelvis.
Although the exact cause of uterine cancer is not known, it is believed that elevated levels of estrogen may play a role, as estrogen is partially responsible for stimulating the lining of the uterus. The symptoms of uterine cancer can change as cancer grows. Often women will experience a change in discharge with a pus-like or blood-tinged appearance. The discharge may also have a foul odour. A change in your normal menstrual cycle is often experienced. Cycles may be longer than seven days, heavier and occur more often. Unexplained vaginal bleeding is often a warning sign.
Worried about abnormal bleeding? Talk to one of our doctors now.
Cervical cancer is caused by the presence of several strains of the human papillomaviruses (HPV) virus. HPV is spread through sexual contact. While the body is usually able to fight off this virus, sometimes it will develop into cervical cancer.
Signs and symptoms of cervical cancer include:
- bleeding between periods
- Heavier and longer menstrual periods
- bleeding after intercourse, pelvic exams, douching or menopause
- increased vaginal discharge
- Pain after sex
- Unexplained and persistent lower back and pelvic pain
Risk factors for cervical cancer include:
- Large number of pregnancies
- If you are HIV positive
- Prolonged use of birth control pills
- Several different sexual partners
Recently on our free doctor chat we had a question asked about a late period . . .
“My period is 27 days late. Urine and blood shows that I am not pregnant but I am having abdominal pain and lots of discharge. What is going on with me?”
One of our physicians posed a few medical questions and some advice
“What does the discharge look like? Are you on any medications? Have you lost or gained weight recently? Have you had any blood tests for levels of testosterone, estrogen, and other hormones in your blood (especially TSH, T3 and T4)? A doctor may not ask to do these tests yet – missed periods are considered a problem if you’ve missed more than three consecutive periods. The most common causes of missed periods in non-pregnant; not-on-birth-control women who are of normal weight are hormone abnormalities. A doctor will likely wait about two weeks, redo the pregnancy test the other hormones. You do need some lab work.”
This helpful medical advice via the online doctor chat may be relevant to your medical issues. You deserve answers and peace of mind, especially when it comes to period problems. Women’s health and wellness is important.
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Disclaimer: This article provides general information and is not intended to diagnose, treat or cure any disease or medical condition. If you require specific advice, please consult one of our medical professionals through the app. However, in case of an emergency, please call 911.
About Richard Honaker M.D.
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