Cycle abnormalities

A typical menstrual cycle lasts between 21 and 35 days, with bleeding for around 4 to 7 days. An abnormal cycle means that your periods fall outside of the norm in some way.

• You get your period more often than every 21 days (polymenorrhea) or less often than every 35 days (oligomenorrhea)
• You’ve missed 3 periods or more in a row (amenorrhea)
• You have a very heavy or light flow
• You bleed for more than 7 days (menorrhagia)
• You experience severe pain and cramping (dysmenorrhea), nausea, or vomiting around your period, or
• You bleed in between periods or after sex (metrorrhagia).

This article has been verified by a medical professional

Impact of cycle abnormalities on fertility

When you get your period more or less frequently than usual or your cycle length fluctuates quite a bit from month to month, it can be difficult to predict ovulation so you have sex at the right time in the month. If you aren’t getting your periods, this often means that you aren’t ovulating. Without ovulation, it’s not possible to get pregnant because there is no egg waiting to be fertilized by sperm. Around 25% of infertility cases are because of not ovulating.

The menstrual cycle is a good window into overall health, and irregularities can sometimes signal that there’s an underlying condition that’s also reducing fertility. Many conditions that affect periods can make it more difficult to conceive and have a healthy pregnancy when they are untreated.

Potential causes of cycle abnormalities

Many things can cause cycle abnormalities, including:

• Lifestyle factors (big weight loss or gain, overly exercising, eating disorders such as anorexia or bulimia, illness, travel, severe stress)
• Hormonal imbalances (especially GnRH, FSH, LH, testosterone, and prolactin)
• Medication (e.g. blood thinners or drugs for anxiety or epilepsy)
• Polycystic ovary syndrome (PCOS)
• Thyroid disorders
• Pelvic inflammatory disease (PID)
• Bleeding disorders
• Diabetes
• Uterine fibroids or polyps 
• Scarring on the uterus
• Endometriosis
• Primary ovarian insufficiency (POI)
• Uterine or cervical cancer

Note that it can take around 6 months for your periods to get back to usual after stopping hormonal birth control. 

For more in-depth knowledge on menstrual abnormalities and what causes them, check out our blog article on irregular cycles.

Diagnosis of cycle abnormalities

Doctors perform many tests to look for the cause of cycle abnormalities. You may have a pelvic exam, Pap smear, vaginal cultures, blood tests, ultrasound of your abdomen, and/or a biopsy of your uterus. A laparoscopy may also be necessary, which is a minimally invasive procedure where a doctor makes a small cut in your abdomen and inserts a thin tube that allows him/her to see your uterus and ovaries.

Treatment to improve fertility

Since there are so many possible reasons for an abnormal menstrual cycle, treatment will look different from woman to woman depending on what’s causing it. This may include medication, surgery, or other procedures such as uterine artery embolization (to cut off blood supply to fibroids). There are also medications available that can make periods and ovulation return so that you can get pregnant. 
Beyond that, leading a healthy lifestyle with plenty of regular exercise and nutritious foods and vitamins can improve cycle abnormalities. You can work together with a LEVY Coach and nutritionist to create a personalized plan that will help regulate your cycle and get your body ready for a successful pregnancy.

This article has been verified by a medical professional

• Abnormal Menstruation (Periods). Cleveland Clinic. Accessed 07 November 2022.
• Irregular periods. NHS. Accessed 15 June 2022.
• Stopped or missed periods. NHS. Accessed 15 June 2022.
• Menstrual Cycle. The Office on Women’s Health from the U.S. Department of Health and Human Services. Accessed 15 June 2022.
• Irregular Periods: Why Is My Period Late? Penn Medicine. Accessed 15 June 2022.
• Heavy and Abnormal Periods. American College of Obstetricians and Gynecologists. Accessed 15 June 2022.
• Intrauterine Adhesions: What Are They? ReproductiveFacts.org from the American Society for Reproductive Medicine. Accessed 15 June 2022.
• Anovulation. Cleveland Clinic. Accessed 07 November 2022.