A typical menstrual cycle spans 21 to 35 days, with bleeding lasting 3 to 7 days. Experiencing two periods in one month deviates from this pattern. While unsettling, this is a common experience, indicating a shift in the body’s usual rhythm.
Understanding Menstrual Cycle Variations
The menstrual cycle is a dynamic process with inherent variability. While 28 days is an average, a range of 21 to 35 days is typical for adults. Cycle length can fluctuate slightly. The cycle is measured from the first day of bleeding until the day before the next period. This helps track individual patterns, as some variation is natural.
Common Reasons for Frequent Periods
Hormonal Imbalances
Frequent periods, or polymenorrhea, often arise from hormonal shifts. Perimenopause, the transition before menopause, involves fluctuating estrogen and progesterone, leading to erratic, shorter cycles. Thyroid disorders, both underactive and overactive, impact reproductive hormones and can cause frequent bleeding. Polycystic Ovary Syndrome (PCOS), a hormonal imbalance, also commonly results in unpredictable and frequent menstruation.
Lifestyle Factors and Medications
Lifestyle factors significantly influence cycle regularity. Stress can disrupt hormonal balance, altering cycle length. Changes in body weight, whether gain or loss, similarly impact hormone production and menstrual patterns. Certain medications, including new or changed hormonal birth control, may induce breakthrough bleeding or shorten cycles.
Structural Issues
Structural issues within the uterus also contribute. Uterine fibroids, non-cancerous growths, can cause more frequent, heavier periods by affecting the uterine lining. Uterine polyps, small growths on the uterine wall, commonly lead to bleeding between periods or frequent, unpredictable bleeding. Reproductive organ infections, such as pelvic inflammatory disease, can also result in irregular, frequent bleeding.
Pregnancy-Related Causes
Frequent bleeding might relate to pregnancy. Light spotting, known as implantation bleeding, can occur when a fertilized egg attaches to the uterine wall early in pregnancy. A miscarriage, especially in early stages, can also present with vaginal bleeding that may be mistaken for a period, varying from light spotting to heavy flow.
When to Consult a Healthcare Professional
Consult a healthcare professional if you consistently experience two periods in a month over several cycles. Seek immediate medical attention if frequent bleeding is accompanied by very heavy flow, such as soaking through one or more pads or tampons hourly for several hours, or passing blood clots larger than a quarter. Symptoms like severe pain, dizziness, extreme fatigue, or shortness of breath may indicate significant blood loss and potential anemia.
Bleeding after sexual intercourse or between expected periods requires medical evaluation. Other concerning symptoms include unexplained weight changes or unusual discharge. These signs suggest an underlying issue that requires professional assessment.
Diagnostic Steps and Treatment Options
When evaluating frequent periods, healthcare professionals begin with a medical history review and physical examination, including a pelvic exam. Blood tests are conducted to assess hormone levels (thyroid function, estrogen, progesterone), check for pregnancy, or signs of anemia. Imaging techniques like a pelvic ultrasound provide views of the uterus and ovaries, identifying structural issues like fibroids or polyps. A hysteroscopy, using a thin scope to visualize the uterine interior, may also be performed.
Treatment depends on the identified cause. Lifestyle adjustments, including stress management, healthy weight, and regular exercise, can influence menstrual regularity. Hormonal therapies, such as birth control pills or progesterone supplements, are commonly prescribed to regulate cycles and reduce bleeding. Non-hormonal medications like NSAIDs or tranexamic acid manage pain and heavy bleeding. If structural issues like fibroids or polyps are the cause, surgical interventions such as polypectomy or myomectomy may be recommended.