A typical menstrual cycle, measured from the first day of one period to the day before the next, generally averages 28 days. However, cycle lengths can naturally vary, ranging from 21 to 35 days in adults and sometimes even longer in adolescents. While this range allows for some variability, experiencing a period twice within a single calendar month often falls outside this typical pattern. Such occurrences can cause concern and may signal an underlying factor. This article explores various reasons why more frequent bleeding might occur and outlines when medical advice is beneficial.
Potential Reasons for More Frequent Bleeding
Hormonal fluctuations often contribute to changes in menstrual frequency. During puberty, a person’s body is still establishing a regular hormonal rhythm, leading to cycles that can be shorter or longer than average. Similarly, perimenopause, the transitional phase leading up to menopause, involves unpredictable shifts in estrogen and progesterone levels, which can result in more frequent or irregular bleeding. Starting or changing hormonal birth control methods can also temporarily disrupt the cycle, sometimes causing breakthrough bleeding or shorter cycles as the body adjusts to new hormone levels.
Beyond hormonal shifts, certain lifestyle factors can influence menstrual patterns. Significant changes in body weight, whether gain or loss, can impact hormone balance and lead to irregular periods. High levels of physical or emotional stress can also affect the body’s hormonal regulation, potentially shortening the time between periods.
More frequent bleeding can also stem from specific medical conditions. Uterine fibroids, benign growths within the uterus, or polyps, overgrowths of cells in the uterine lining, can cause heavier and more frequent bleeding. Thyroid disorders, such as hypothyroidism or hyperthyroidism, directly affect hormone regulation, leading to menstrual irregularities, including more frequent periods. Polycystic Ovary Syndrome (PCOS), a hormonal disorder, often results in irregular ovulation and can manifest as varying cycle lengths, including shorter, more frequent periods.
Additionally, certain sexually transmitted infections (STIs) or pelvic inflammatory disease (PID) can cause inflammation and bleeding, disrupting the normal cycle. Less commonly, bleeding disorders that affect blood clotting can lead to prolonged or heavy bleeding, which might be perceived as very frequent periods.
When to Seek Medical Attention
It is advisable to consult a healthcare professional if you consistently experience periods too frequently, especially if your cycles are regularly shorter than 21 days. Very heavy bleeding, defined as soaking through one or more pads or tampons every hour for several hours in a row, or needing to change protection during the night, also warrants medical evaluation. Severe menstrual pain that interferes with daily activities or is a new symptom should also prompt a doctor’s visit.
Bleeding between periods or after sexual intercourse are important indicators that require professional assessment. Any bleeding during pregnancy, even light spotting, should be immediately reported to a doctor. Sudden and unexplained changes in your typical cycle pattern are also reasons to seek medical advice. Accompanying symptoms like fever, unusual vaginal discharge, dizziness, or persistent fatigue can further signal an underlying issue that needs prompt medical attention.
Diagnosis and Management Approaches
The diagnostic process for frequent bleeding typically begins with a detailed medical history, including questions about your menstrual patterns, overall health, and other symptoms. This is followed by a physical examination, usually including a pelvic exam. To identify potential causes, laboratory tests may be ordered. These include blood tests for pregnancy, hormone levels (such as thyroid-stimulating hormone and prolactin), a complete blood count to assess for anemia, and tests for bleeding disorders.
Imaging studies are frequently used to visualize the reproductive organs. A transvaginal ultrasound is a common procedure that can detect structural abnormalities like uterine fibroids, polyps, or ovarian cysts. In some cases, a sonohysterogram, involving saline introduction during an ultrasound, can provide more detailed images of the uterine lining. If imaging reveals suspicious areas or concerns, an endometrial biopsy, where a small tissue sample is taken from the uterine lining, might be performed.
Management of frequent bleeding focuses on addressing the underlying cause. If hormonal imbalances are identified, medication adjustments or hormonal therapies, such as birth control pills or progestin-only treatments, can regulate the cycle and reduce bleeding. Lifestyle modifications, including stress management, dietary changes, or weight management, may be recommended if contributing to irregularity. For structural issues like fibroids or polyps, surgical intervention, such as hysteroscopy, may be considered. In certain situations, procedures like endometrial ablation, which destroys the uterine lining, might be an option if future pregnancy is not desired.