Skipped, spotty, nonexistent periods? The most important first step is to discover the reason. Here are the most 15 most common causes of period problems, plus fixes that will help you quickly and easily regain control of your menstrual cycle.
The most important thing to remember is that your hormones are key to regulating your periods. The reason your menstrual cycle is spotty, nonexistent, or super heavy is because of hormonal imbalances in your body. The good news is that problem periods caused by hormonal imbalances can be fixed by eating the right foods, getting enough exercise, and sleeping well. The bad news is that some hormonal imbalances aren’t quickly or easily fixed. Why? Because some hormonal imbalances are caused by more serious medical conditions, such as endometriosis, PCOS (polycystic ovarian syndrome), or even a thyroid condition. Those are common causes of problems, but the solution is a little more involved than simply eating right and exercising.
Before we get too far ahead of ourselves, let’s look at the reasons your periods are not regular.
In 9 Easy Healthy Ways to Make Your Menstrual Cycle Regular we learned the importance of getting the right nutrients into your body. Food is a surprisingly powerful way to take care of common period problems! Both naturopathic physicians and traditional Western medical doctors agree that food is crucial to overall health and wellness.
“One of the most important factors in health – perhaps the most important from a functional medicine point of view – is food,” writes Marcelle Pick in Is It Me or My Hormones?: The Good, the Bad, and the Ugly about PMS, Perimenopause, and All the Crazy Things that Occur with Hormone Imbalance?
“Accordingly, I view food as medicine. One of my first concerns—as you’ll see in this book—is to make sure that my patients are eating the foods that can make them well, and avoiding the foods that can make them sick. Sugar, refined carbohydrates, trans and hydrogenated fats, preservatives, and artificial ingredients can be particularly toxic and are often implicated in hormonal issues as well as in many other health concerns. My functional-medicine colleagues and I understand that we can literally use food to shift a patient’s biochemistry, often with dramatic results.”
What have you eaten today? Are your meals energizing and fueling your body, or draining and depleting you? Take time to take stock of how your diet affects your energy levels. Each morsel of food not only affects your hormones – it is also possibly causing problems with your period.
15 Causes of Problems With Your Period
Another important thing to remember is that every woman is different. This means that what’s creating problems in your menstrual cycle may not be causing problems in your sister’s or mom’s or best friend’s cycle. You may live or work together, you may even share a bedroom and bathroom, but you may have totally different causes of problem periods.
Your genetics and biological makeup is different than your closest family member’s – even if you are identical twins! Not only do you have different causes of menstrual problems, you also have different solutions. This means that increasing your intake of, for example, omega-6 fatty acids or magnesium may help you solve your period problems but they’ll do nothing to regulate your sister’s menstrual cycle.
A Quick List of Factors That Cause Problems in Periods:
- Significant weight gain or loss
- Poor nutrition (or a diet too high in carbohydrates)
- Excessive amounts of caffeine
- Excessive alcohol and/or drug use
- Eating disorders
- Increased stress
- Polycystic ovarian syndrome/Estrogen dominance
- Uterine abnormalities (fibroids, uterine cysts, polyps, endometriosis)
- Hormonal imbalances related to perimenopause
- Prescription medications
- Recent childbirth, miscarriage, or D&C
As you can see, there are many different reasons that your menstrual cycle isn’t regular. And, there may be more than one thing happening at once. For example, if you’re smoking cigarettes, drinking Red Bulls and vodka, and not eating a healthy balanced diet because you’re stressed over not having a regular menstrual cycle, then you have successfully covered 5 of the 15 most common period problems (cigarettes, caffeine, alcohol, poor nutrition, and stress).
Determining the exact cause of your problematic menstrual cycle can be difficult and confusing…which makes finding a “quick solution” for your period problems even harder. But take heart! We’ll go through each reason many women have problems with her period. If any of them stand out to you (eg, you’re one of those Red Bull-drinking stressed out women), then you know where to start looking for your solution.
Also – keep in mind what type of period problem you’re dealing with. Some of these causes – such as anorexia or smoking, for example – lead to very specific types of irregularities. Read 4 Most Common Types of Menstrual Problems for Women if you need help defining or classifying your periods.
1. Significant weight gain or loss
Your weight has a significant effect on your menstrual cycle; if you’re overweight, basic cholesterol compounds in your fat cells can get changed into a type of weak estrogen called estrone. If you’re overweight or obese, you have extra fat cells have that make lots (too much) estrone or weak estrogen. This extra estrogen can cause problem bleeding or menstrual disorders. You may go months without ovulating, but your uterine lining is still accumulating — to the point that it becomes unstable. Eventually you’ll have a super heavy and/or long period.
Quick fix: In The Food Babe Way: Break Free from the Hidden Toxins in Your Food and Lose Weight, Look Years Younger, and Get Healthy in Just 21 Days!, food activist Vani Hari – aka the Food Babe – describes an easy and accessible plan to rid your body of toxins, lose weight without counting calories, and restore your natural glow in just 21 days. Including anecdotes of her own transformation along with easy-to-follow shopping lists, meal plans, and mouthwatering recipes, she will empower you to change your food, change your body, and change the world.
If you’re underweight – about 10% under normal weight – many hormonal functions in your body are changed. This, too, causes problems with your period. “Primary amenorrhea (no period at all) is fairly common in teenage girls who are very thin or very athletic,” write the MayoClinic doctors in Amenorrhea. “These young women are typically underweight. Their bodies have not experienced the normal puberty-related rise in body fat. This rise in body fat triggers the beginning of menstruation. In other girls, the delay of menstruation may be caused by a genetic disorder. Or it may result from abnormal female reproductive organs.”
- Quick fix (you’ll do more than just solve your period problems if you get a grip on this): See the solution to “Problem Period #3” below. If you aren’t sure why you’re overweight or underweight, talk to a doctor, dietician, or nutritionist. There may be something else going on in your body that’s causing weight loss or weight gain.
2. Excessive exercise (not the most common cause of period problems)
Are you an athlete? If you participate in activities that require rigorous training (eg, ballet, competitive body sculpting, Olympic-level sports, etc), you may find your menstrual cycle interrupted. Professional ballet dancers, gymnasts, and ice skaters are especially at risk for menstrual disorders because they combine strenuous physical activity with a diet intended to keep their weight down. Common causes of the overexercise/problem period phenomenon include low body fat, high physical and emotional stress, and high energy expenditure.
Are you using steroids to improve your athletic performance? The illicit use of anabolic steriod drugs to enhance athletic performance will also cause problems with your period. Menstrual irregularities are now known to be one of the three disorders comprising the so-called “female athlete triad,” the other disorders being disordered eating and osteoporosis.
- Quick fix: Talk to your coach (or yourself) if you’re concerned about how your exercise routine is affecting your menstrual cycle. Prioritize overall health over winning the competition or being the best ballerina on the block.
3. Poor nutrition (or a diet too high in simple carbohydrates)
The food you eat has both immediate and long-term effects on your mood, body, and overall health. If you eat lots of fast foods and simple carbohydrates, you aren’t giving your body the nourishment it needs. If you eat sporadically, miss meals and diet constantly – you essentially send your body into “survival mode.” Your body thinks she’s starving and so shuts down unnecessary systems. One of those “unnecessary systems” is your period. This is problematic! Your body won’t cycle regularly.
The solution to this period problem is simple: take the time to make the healthiest choices you can. Avoid those awful (but delicious!) bags of salty Old Dutch potato chips or pints of chocolate chip cookie dough ice cream. Fill up on the good stuff.
Go easy on yourself…no matter how small the changes you’ve made to your diet, you may have days when you just can’t eat healthy. This is perfectly normal, so don’t beat yourself up! Enjoy them, and then continue again the next day with your healthier eating plan. Treat yourself occasionally – but try not to break your healthy plan in the few days before and during your period. Eating healthy around and during your menstrual cycle will help you avoid problems.
- Quick fix: Learn what healthy foods are and how they affect your body. Notice how good you feel physically and emotionally when you eat nutritious food.
4. Smoking (a surprisingly common cause of problem periods)
Cigarettes are so harmful to your health! Smoking can cause ectopic pregnancy and premature menopause. It increases your risk of cervical and rectal cancer. In fact, a Danish study published in the Journal of the National Cancer found that premenopausal women who smoke are six times more likely to develop rectal cancer than those who don’t.
Smoking also makes period problems worse. Women who smoke experience more severe premenstrual symptoms and have a 50% increase in premenstrual and menstrual cramps, which can last two or more days.
- Quick fix (easier said than done): Quit smoking. Yes, it’s hard – it took me a year to actually feel free from the nicotine and habit changes of smoking. Yes, it’ll be worth it! Smoking is gross, in addition to being unhealthy.
5. Excessive amounts of caffeine
“Drinking caffeine may actually exacerbate uncomfortable symptoms of a woman’s menstrual cycle,” writes Anna-Sofie Hickson in The Effects of Caffeine on a Woman’s Menstrual Cycle. “According to Dr. Joseph Mercola, New York Times best-selling author and founder of Optimal Wellness Center in Illinois, caffeine consumption is linked to elevated estrogen levels, which increases the risk of developing breast and endometrial cancers. Mercola believes that while coffee does present certain health risks, caffeinated beverages like soda and fruit juice are far more detrimental to a woman’s health. Eliminating or decreasing caffeine from your diet may be beneficial to your health and alleviate discomfort during your menstrual cycle.”
If your period problems include PMS, note that women who consume large amounts of caffeine experience more problematic premenstrual syndrome symptoms than women who don’t eat or drink caffeine. PMS discomfort may include cramping, headaches, breast tenderness, bloating, mood swings, backaches, fatigue and irritability. Caffeine is a stimulant drug that increases blood pressure and heart rate – and, an increased consumption of caffeine leads to tension, anxiety, trouble sleeping and amplified exhaustion.
- Quick fix: Cut down on the caffeine. If you’re a heavy caffeine consumer, you might try cutting down slowly so you don’t go through severe withdrawal symptoms.
6. Excessive alcohol and/or drug use
Alcohol can temporarily increase levels of estrogen and testosterone, which has a direct effect on your menstrual cycle. How? By changing when you ovulate and thus messing with your period. While it does take a lot of alcohol and other drug use to drastically and permanently change your hormones, it’s still not good for your body to drink more than one glass of wine a day. And drugs? There is no safe level, no “moderate” level of drug use.
- Quick fix: Quit drinking and doing drugs! Seriously. If you’re addicted to drugs or alcohol, start thinking about ways to change your life and overcome your addiction.
7. Eating disorders
Women who have an eating disorder – such as anorexia or bulimia – often stop having periods because of hormonal changes. It’s not just anorexia nervosa that causes problems with your period because of low body weight and stress; any type of eating disorder can boost your likelihood of having an irregular menstrual cycle. If you’re missing your periods, your risk of osteoporosis is higher and your fertility levels are lower.
- Quick fix: If you’re struggling with an eating disorder and you’re ashamed or embarrassed to talk about it, write in the comments section below. I had bulimia for 20 years…such a long time! It didn’t cause problems with my periods because I “only” binged and purged once or twice a week. I’d be happy to share how I recovered from my eating disorder with you.
8. Increased stress (one of the most common causes of period problems)
When you’re stressed because of work, family, marriage, children, an upcoming move, trying to get pregnant, etc) your adrenal glands secrete lots of the stress hormone cortisol. Cortisol has a direct impact on the hormones estrogen, progesterone, and DHEA. Mental or emotional stress can temporarily change how your hypothalamus functions (the hypothalamus is an area of your brain that controls the hormones that regulate your menstrual cycle). Problems with your hypothalamus means problems with your period! Ovulation and menstruation may stop if you’re feeling stressed – but the good news is that you can get back to a regular menstrual cycle if you learn how to deal with stress.
Eating disorders, dieting, drug use, and reliance on stimulants like caffeine and alcohol are also interpreted by the body as types of stress. Poor nutrition seems to physically change the proteins in the brain so they can no longer send the proper signals for normal ovulation.
- Quick fix (not just for this period problem – for your whole life): Learn how to deal with stress! You’ll never completely eliminate stress from your life, but you can learn how to manage it so you’re not physically and emotionally affected by stressful events and people.
9. Polycystic ovarian syndrome (excess estrogen)
Polycystic ovary syndrome (PCOS) causes relatively high and sustained levels of hormones – especially estrogen – rather than the fluctuating levels seen in the normal menstrual cycle. PCOS is a common endocrine system disorder that causes problem or irregular periods. It also leads to enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary as seen during an ultrasound exam.
According to WomensHealth.gov, Polycystic ovary syndrome is triggered by an imbalance of reproductive hormones. This hormonal imbalance creates problems in the ovaries, which leads to period irregularities. Your ovaries make the egg, which is released each month as part of a normal healthy menstrual cycle. If you have PCOS, the egg may not develop as it should or it may not be released during ovulation. PCOS causes missed or fewer periods (less than eight in a year). Or, your period may show up every 21 days – or even more often than that. Some women with PCOS stop having menstrual periods altogether.
- Quick fix: Sorry, there’s no fast or fast or easy solution for PCOS…you need to book an appointment with a gynecologist, obgyn, or family physician. Get the necessary tests to find out if you have PCOS.
10. Uterine abnormalities (e.g., fibroids and endometriosis)
Uterine fibroids (which I have) are noncancerous growths of the uterus. They can cause heavy menstrual periods and prolonged menstrual periods. “Fibroids or leiomyomas are noncancerous tumors that form in the uterus,” write the WebMD experts in Menstrual Blood Problems: Clots, Color, and Thickness.
“Fibroids do not always cause symptoms or [problem periods]. In fact, increasing research information suggests that most women with small ‘fibroid’ tumors have no symptoms at all. But women with fibroids may notice greater than usual amounts of menstrual blood. If you have fibroids, you may have more clots in your period than you had in the past.” Yup.
Endometriosis occurs when tiny bits of endometrial tissue or clumps of cells are carried out of the uterus and into the pelvic cavity by your menstrual flow. In most cases, your immune system is able to dispose of any stray endometrial cells floating around. But sometimes those fragments of cells come into contact with scarred or injured tissue…and both endometriosis and painful periods are born. Those cells attach themselves to their new home and immediately start to reproduce. Those little endometrial cells can make their new homes on the diaphragm, fallopian tubes, ovaries, bladder, intestines, or even inside the abdominal cavity. They grow into little colonies, thickening and building up when exposed to estrogen. When estrogen levels drop, they bleed. The cycle eventually causes scarring wherever the colonies have landed, as well as the formation of cysts. Since endometriosis is a progressive disease, it ultimately leads to chronic discomfort, backache, nausea, and pain during sex and/or bowel movements.
- Quick fix: Nothing fast or easy. Get an ultrasound from a fertility doctor or gynecological specialist. Talk about the pros and cons of different treatments for fibroids, cysts, polyps, and endometriosis removed. For instance, my doctor and I decided I’d keep my fibroids because they weren’t growing or causing problems with my period. Except for the clumps and clots.
11. Hormonal imbalances related to perimenopause
If you’re in perimenopause (like I am!), then you’re approaching menopause. Menopause is official when you have not gotten your period for one full year.
“Perimeopause refers to the time before menopause when hormone levels, particularly estrogen, begin fluctuating,” writes Dr Wulf Utian in Irregular Periods and Perimenopause on the HealthyWoman.org website. “Perimenopause occurs, on average, about four years before actual menopause. Menopause is timed as the date of the final period, confirmed after periods have been missed for 12 months. In the meantime, however, your hormones are all over the place. Some months, levels of estrogen and/or progesterone are up, and some months they’re down. All of which affects your periods.”
If you’re perimenopausal, you may not have a “normal” period for months…and then you may get a period that’s so heavy that you don’t want to leave the house. Talk about “period problems” – your period may last four days or two weeks. You may skip a month or have spotting between cycles. You may find your period comes every 28 days or every 65 days. There’s just no telling.
- Quick fix: Dr Utian says that when a firm diagnosis that you’re in perimenopause is reached, there are numerous options available to help regulate your periods – especially if you’re having painfully heavy bleeding. Solutions include medications such as oral contraceptives, a hormone-releasing IUD, a surgical procedure called endometrial ablation (the lining of the uterus is destroyed), or, in severe cases, a hysterectomy.
12. Prescription medications
Many prescription and nonprescription medicines can affect the menstrual cycle. A few examples are:
- Anticoagulant medicines, such as aspirin and warfarin (such as Coumadin).
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (for example, Advil or Motrin) and naproxen (for example, Aleve).
- Hormonal forms of birth control, such as birth control pills, Depo-Provera injections, Implanon or Nexplanon implants, and the levonorgestrel IUD (Mirena).
- Hormone therapy.
- Medicines used to treat cancer (chemotherapy).
- Thyroid medicines.
Any prescription medication that involves hormones – such as thyroid medication (and thyroid problems in general), steroids, or antipsychotics (which release a hormone called dopamine) – will cause problems with your period.
Also – hormones don’t act in isolation. All your hormones circulate throughout your body and bloodstream. They’re all interrelated and interconnected, and they interact with each other in significant ways.
- Quick fix: Ask yourself if you really need to take those nonprescription medications (e.g., aspirin, ibuprofen, etc). Ask your doctor if you should keep taking the prescription meds. Never stop taking prescribed medications without talking to your doctor first – even if they’re on this list of the most common causes of period problems! Talk to your doctor first, to ensure you’re making the right decision.
Are you a cancer survivor? Congratulations! You must be thrilled to be alive and well – but your menstrual cycle may have taken a hit while you were getting chemotherapy treatments. Some chemo drugs can damage the ovaries and cause problems with your period. If you’re under 40, your menstrual cycle is likely to re-establish itself as you gain strength and health. If you’re over 40, period problems caused by chemo drugs are often permanent. This may mean that menopause begins earlier than you expected.
- Quick fix: Give your periods time to find themselves. If it’s been months, talk to your oncologist about the possible reasons you’re still having period problems. If it’s been years, you’re probably in menopause.
14. Recent childbirth or a miscarriage (two common causes of period problems)
Recent childbirth. If you’re not breast feeding after having a baby, your period should return to normal within 10 weeks. Every woman is different, though, so you may get your period sooner or later. Some new moms don’t have regular menstrual cycles for up to 20 weeks after giving birth. Other women find their period returns the very next month after giving birth.
Miscarriages and menstrual problems. In Irregular Periods After Miscarriage: What You Need to Know Bonnie Gibbs Vengrow says there are several common reasons for irregular periods after miscarriage. According to Siobhan Dolan, M.D., an attending physician in the Division of Reproductive Genetics at Montefiore Medical Center, the University Hospital for Einstein, in New York City, problem periods may be caused by a clot or residual tissue in the uterus.
“If you have a miscarriage within the first few weeks of pregnancy, it will look and feel a lot like a regular period,” writes Vengrow. “Around 6 to 7 weeks, it’s more akin to a heavy period. But if you’re farther along – say, 10 to 11 weeks or more – your uterus has to flush out more tissue and possibly some placenta, which could take a while.”
- Quick fix: Give your body time to recover. Call your ob-gyn or gynecologist if you’re still spotting after a few weeks.
If you’re nursing a little baby, your menstrual cycle will be suppressed for a while. Some women do not get their period for weeks, months, and even years while they’re breastfeeding. Some mothers need to completely wean their babies before their period returns to normal (or semi-normal). Other breastfeeding moms get regular menstrual cycles when their babies start taking supplemental foods or sleeping longer at night.
When your period returns after your breastfeeding adventures, it may not be “normal.” That is, it may not be the same as it was before you got pregnant. Your body is changing all the time, especially after childbirth and if you are trying to conceive again.
- Quick fix: Is it time to stop breastfeeding? Follow your instincts, talk to a midwife or childcare expert, consider what’s best for your baby and family as a whole. You may choose to live with an irregular menstrual cycle while breastfeeding, and rest in the knowledge that your period will return when your baby is weaned.
In 8 Surprising Benefits of Getting Your Period, I describe the many ways your monthly cycle increases your overall health and wellness. Your period is a natural cleansing process that releases bacteria from inside the reproductive system and helps the body to discharge excess iron, which can help lower the risk of cardiovascular disease.
So, not only do you want to find the best solutions and quick fixes to period problems for convenience’s sake, you also want to keep your body functioning at optimal levels.
3 Less Common Causes of Problem Periods
According to the Mayo Clinic, structural problems or abnormalities with your reproductive organs themselves also can cause missing periods (amenorrhea).
1. Uterine scarring
Asherman’s syndrome, a condition in which scar tissue builds up in the lining of the uterus, can sometimes occur after a dilation and curettage (D&C), cesarean section or treatment for uterine fibroids. Uterine scarring prevents the normal buildup and shedding of the uterine lining.
2. Lack of female reproductive organs
Sometimes period problems arise during fetal development that lead to a girl being born without some major part of her reproductive system, such as her uterus, cervix or vagina. Because her reproductive system didn’t develop normally, she can’t have menstrual cycles.
3. Structural abnormality of the vagina
An obstruction of the vagina may prevent visible menstrual bleeding or problems with your period. A membrane or wall may be present in the vagina that blocks the outflow of blood from the uterus and cervix.
This is a lot of information about the reasons you may be having a problematic menstrual cycle! How are you doing? Feel free to share your thoughts with me below. I can offer no medical advice or feedback, but you may find it helpful to write about your concerns, fears, or history of period problems.
These last three “less common causes of period problems” are from TheMayoClinic.com.
Help for the Most Common Period Problems
Yogi Teas – St. John’s Wort “Blues Away” is a warming and soothing tea that contains St. John’s wort. This herb helps ease tensions and nervousness by settling emotional imbalances caused by everyday stress; the soothing fennel and lively, aromatic organic lavender helps promote a sense of calm. It’s naturally caffeine free.
St. John’s wort is most commonly used for depression, anxiety, fatigue, loss of appetite and trouble sleeping. There is some strong scientific evidence that it is effective for mild to moderate depression. Other uses include heart palpitations, moodiness and other symptoms of menopause, mental disorders that present physical symptoms, premenstrual syndrome (PMS), attention deficit-hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), social phobia, and seasonal affective disorder (SAD).
St. John’s wort might cause serious interactions with some prescription and nonprescription drugs. Before you try it as a “quick fix” for period problems, talk to your doctor.
Nature’s Way Black Cohosh Root is a dietary herbal supplement for women with mild estrogen activity (low estrogen levels). It helps with problems during menstruation and menopause, such as hot flashes, bloating, insomnia, painful periods, and even erratic thoughts and feelings.
According to WebMD, black cohosh has commonly been used to treat symptoms of menopause, premenstrual syndrome (PMS), painful menstruation, acne, weakened bones (osteoporosis), and for starting labor in pregnant women.
How do you feel, after reading all this information on the most common causes and quick fixes for problem periods? I welcome your comments and thoughts below! I can’t offer medical or health advice or feedback, but you may find it helpful to share your experience.
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Irregular periods aren't just frustrating; they're warning signs! Getting regular periods will improve your overall health, increase your energy, and help you avoid future health problems.