Abnormal periods occur across adolescence, reproductive years, and into perimenopause. While some changes reflect natural variation, some irregularities may signal underlying issues worth discussing with a clinician. Tracking key details such as start dates, cycle length, flow amount, and any pain or spotting throughout a few months can make patterns more visible and help guide future medical appointments. Changes that disrupt life or bring new discomfort are best discussed with a doctor who specializes in gynecology.
What Counts as an Abnormal Period?
Gynecology clinicians reference typical ranges but focus on what is new or unusual for your pattern. Abnormal uterine bleeding includes cycles less than 21 days apart or more than 35 days, unpredictable timing, or unexpectedly heavy bleeding. Bleeding that occurs between periods or after intercourse is also considered abnormal. Some cycle changes may be explained by stress, travel, or temporary hormonal shifts, but persistent or pronounced patterns, as well as any bleeding after menopause, should be discussed with a specialist.
What Can Cause Them?
Irregular or abnormal bleeding can result from many causes. Hormonal shifts are often seen during perimenopause, when ovulation can be inconsistent and cycles less predictable. Changes in the uterus, such as fibroids or polyps, may contribute to heavier or prolonged flow, with sizes and impacts varying between individuals. If ovulation does not occur in a cycle, timing and flow may be abnormal. Irregularities regarding the endometrial lining may result in variations in bleeding.
Systemic conditions like thyroid disorders, changes in blood clotting, or weight fluctuations can all affect menstruation. Some medications may alter bleeding patterns. Major life stressors, shift work, sleep changes, and intense exercise may disrupt normal hormonal rhythms, leading to irregular cycles. Though not every irregularity needs medical management, understanding what is behind these symptoms helps you and your clinician identify an approach.
How Does Gynecology Diagnose Them?
Gynecologic assessment begins with a detailed clinical history. This can cover timing, duration, flow, accompanying symptoms, current medications, and prior reproductive conditions. Physical examination is usually part of this process, including a general and pelvic exam to evaluate the uterus and other pelvic structures. If visible abnormalities such as polyps are identified, these may be addressed directly. Based on clinical findings, lab tests may be recommended. These tests help determine overall health, blood loss, or hormonal influences on the cycle.
Imaging is often used in the diagnostic process. Pelvic ultrasound is frequently used, offering insight into the uterus and ovaries while identifying any fibroids, polyps, or anatomical differences. When a polyp or similar finding is suspected, hysteroscopy enables direct examination of the uterus and possible targeted treatment in the same session. Diagnostic pathways are individualized, taking your age, specific symptoms, risk factors, and goals into account. Most diagnoses rely on a combination of clinical history, examination, and imaging, with lab testing adding clarity when needed.
Consult Your Gynecologist About Treatment
Seeking guidance does not require your symptoms to become severe. A scheduled visit with a gynecologist helps determine whether changes align with typical variation or require further assessment. Your clinician can outline choices, clarify benefits and drawbacks, and work with you toward practical solutions.
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