A menstrual period is the monthly shedding of the uterine lining, preparing the body for potential pregnancy. While a typical menstrual cycle averages 28 days, normal cycles can range from 21 to 35 days, with bleeding lasting between 3 to 7 days. Variations in bleeding patterns, such as a period starting and then stopping, are common.
Common Explanations for Irregular Bleeding
Hormonal fluctuations often contribute to changes in menstrual bleeding patterns. Factors like stress, significant shifts in diet or exercise, weight changes, travel, and sleep disruption can influence the hormones regulating the menstrual cycle, leading to a period that begins and then pauses.
Spotting that starts and stops may indicate early pregnancy, specifically implantation bleeding. This occurs when a fertilized egg attaches to the uterine lining, typically 6 to 12 days after conception, around the time a period would be expected or a few days earlier. Implantation bleeding is usually lighter, less consistent, and often appears pink or brown, differing from the typically heavier, bright red flow of a regular period.
Different birth control methods are a frequent cause of irregular bleeding. When starting, stopping, or changing hormonal contraceptives (e.g., pills, injections, implants, patches, IUDs), the body adjusts to new hormone levels. This adjustment period, particularly in the first months, can result in breakthrough bleeding or spotting between expected periods. Progestin-only methods and low-dose combination pills are especially associated with such changes.
Perimenopause, the transitional phase leading up to menopause, frequently involves irregular bleeding patterns. During this time, fluctuating estrogen and progesterone levels can cause periods to become unpredictable, with variations in length, flow, and duration, including spotting between cycles. Minor irritation or infection of vaginal or cervical tissues can similarly lead to light bleeding or spotting that may start and stop.
Potential Medical Factors
Less common, but more significant, medical conditions can also cause a period to start and stop. Polycystic Ovary Syndrome (PCOS) is a hormonal disorder where the ovaries produce higher levels of androgens. This can disrupt ovulation, leading to irregular periods, infrequent bleeding, or even the complete absence of menstruation.
Thyroid disorders (hyperthyroidism and hypothyroidism) significantly affect menstrual cycles. The thyroid gland produces hormones that influence reproductive hormone production. An imbalance can lead to periods that are very light, heavy, irregular, or even stop entirely by impacting ovulation.
Uterine fibroids and polyps are non-cancerous growths that can develop in or on the uterus. Fibroids are muscular tumors within the uterine wall; polyps are tissue overgrowths on the uterine lining. Both can cause abnormal bleeding, including bleeding between periods, prolonged or heavy menstrual flow, and sometimes postmenopausal bleeding.
Endometriosis, where tissue similar to the uterine lining grows outside the uterus, can cause irregular periods. This misplaced tissue responds to hormonal changes, leading to pain and abnormal bleeding, including spotting between periods or heavy, irregular flow. Certain medications, beyond hormonal contraceptives, can alter menstrual patterns. Blood thinners like aspirin and warfarin can increase bleeding intensity, while some antidepressants, antipsychotics, and antiepileptic drugs may cause irregular or absent periods.
When to Consult a Doctor
Seeking medical advice is advisable if irregular bleeding patterns persist or worsen. If you experience unusually heavy bleeding (e.g., soaking through one or more pads or tampons every hour for several consecutive hours, or passing large blood clots), a doctor’s visit is warranted. Bleeding that lasts longer than seven days is also a reason for concern.
Associated symptoms like severe pain, fever, unusual vaginal discharge with an unpleasant odor, dizziness, or fatigue accompanying irregular bleeding should prompt medical evaluation. Bleeding after menopause (12 months without a period) is always a reason to consult a healthcare professional. Any new or unusual bleeding patterns that cause concern, especially if pregnancy is possible, should also be discussed with a doctor.
Preparing for a Doctor’s Visit
To make the most of a medical consultation, gather relevant information beforehand. Track your menstrual cycles, noting start and end dates, bleeding duration, and flow intensity. Document any associated symptoms, such as pain, fatigue, or mood changes, for valuable insights.
List all current medications, including prescription drugs, over-the-counter medicines, and supplements. Mention recent lifestyle changes, such as significant stress, diet modifications, or exercise routines, as these can be relevant. Prepare a list of questions for your doctor to ensure all concerns are addressed during the appointment.