When Should I Worry About Irregular Bleeding?

Women learn during puberty that a period should occur every 28 days. However, many women don’t menstruate with that level of regularity. What is normal? The fact is that normal can range significantly from woman to woman. Many women don’t think about periods too much until trying to get pregnant. And while abnormal uterine bleeding (AUB) can make getting pregnant more tricky, starting a family is not impossible.

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What’s considered abnormal?

In general, women should have a period around every 21-35 days, and the bleeding should last for 4-8 days. Anything outside that range may be a cause to see a healthcare provider. Some women are simply unlucky: many women bleed for longer than 8 days but are consistent in this pattern. If a woman’s menstrual cycle doesn’t fall into normal parameters but is consistent, there may not be cause for concern. Especially if there are no other symptoms such as pelvic pain or extremely heavy bleeding, being a little out of the norm is probably okay.

How will irregular periods affect getting pregnant?

Regular periods are a crucial indicator of fertility. In fact, AUB accounts for about 30-40% of all cases of infertility. However, that doesn’t mean that having irregular periods means a woman can’t get pregnant. There may simply be other factors to consider.

Are there underlying conditions?

If abnormal bleeding is due to an underlying condition like endometriosis or polycystic ovary syndrome (PCOS), women may need a little help getting pregnant. For example, assisted reproductive technology (ART) options like in vitro fertilization (IVF) can be a helpful solution for many women with endometriosis and other conditions that impact fertility.

Are you ovulating?

While women should pay attention to periods, the key metric in getting pregnant is ovulation. Women can still track ovulation with irregular periods. Using an app that tracks periods may not be enough if a woman is inconsistent. Instead, evaluating other physical indicators of ovulation, such as changes in cervical mucus or basal body temperature spikes, maybe more helpful.

What else can I do?

There are other lifestyle factors that can impact fertility. Engage in a moderate amount of exercise, eat a nutrient-dense diet, and try to minimize and manage stress as much as possible. Couples who have been attempting to conceive for 6-12 months without success may consider speaking with a fertility specialist. These healthcare providers can provide assessments and treatment options to assist with getting pregnant.

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