What's "irregular"?
A typical cycle is 21 to 35 days. Yours may be irregular if cycles are consistently shorter or longer than that, vary wildly month to month, or stop for months at a time. Occasional variation is normal — a persistent pattern is worth evaluating.
Common causes
- PCOS — the most common cause of chronic irregularity in reproductive-age women.
- Thyroid disorders — both over- and under-active thyroid disrupt cycles.
- High prolactin — can suppress ovulation.
- Stress and under-fueling — significant stress, very low body weight, or intense exercise can pause cycles.
- Perimenopause — cycle changes often begin in the late 30s to 40s.
- Medications — including some antidepressants, antipsychotics, and hormonal contraceptives.
- Coming off birth control — cycles can take several months to regulate.
When irregular periods need prompt attention
- Bleeding that soaks through a pad or tampon every hour for several hours
- Bleeding between periods or after sex, repeatedly
- No period for 3+ months (and you're not pregnant or on hormonal contraception)
- Severe pain with periods
- Any bleeding after menopause — always get this checked promptly
How we evaluate it
By video, we take a detailed cycle history (bring your best estimates — apps help), review symptoms, and order targeted labs. Most causes of irregular cycles are very treatable once identified.
Frequently Asked Questions
Is it bad to skip periods?
Occasionally missing one period usually isn't an emergency, but going months without bleeding deserves evaluation — the uterine lining can build up when ovulation doesn't occur regularly.
Can stress really stop my period?
Yes. Significant physical or emotional stress can suppress the brain signals that drive ovulation. But 'stress' should be a diagnosis of exclusion — thyroid, PCOS, and other causes should be ruled out first.